Provider Demographics
NPI:1528573128
Name:ADKINS, DOMINIQUE PIA (LPC, ED D)
Entity Type:Individual
Prefix:DR
First Name:DOMINIQUE
Middle Name:PIA
Last Name:ADKINS
Suffix:
Gender:F
Credentials:LPC, ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8119 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3135
Mailing Address - Country:US
Mailing Address - Phone:703-799-2890
Mailing Address - Fax:
Practice Address - Street 1:8119 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3135
Practice Address - Country:US
Practice Address - Phone:703-799-2890
Practice Address - Fax:703-360-0899
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health