Individual
DOROTHY CLARK DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-4918
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-4918
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004909
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904004909
LCSW
VA
Enumeration date
04/14/2008
Last updated
10/07/2024
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