Provider Demographics
NPI:1235483710
Name:DOTSON, CAROL J
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:J
Last Name:DOTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 S GALVEZ ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-3102
Mailing Address - Country:US
Mailing Address - Phone:504-332-5713
Mailing Address - Fax:504-350-8436
Practice Address - Street 1:2300 S GALVEZ ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-3102
Practice Address - Country:US
Practice Address - Phone:504-332-5713
Practice Address - Fax:504-350-8436
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA4997101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator