Organization
AUGUSTUS C. DICKENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AUGUSTUS CHADWYCK DICKENS I LCPC (LICENSE CLINICAL PROFESSIONAL COUN)
(301) 257-1430
Entity
Organization
Contact information
Practice address
9811 MALLARD DR, LAUREL, MD 20708-3143
(301) 257-1430
Mailing address
1417 WINTER PINE TRL, SEVERN, MD 21144-1506
(301) 257-1430
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC6378
MD
Other
Enumeration date
06/14/2015
Last updated
06/14/2015
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