Provider Demographics
NPI:1659779387
Name:DINKINS, CHARLES LEE (MPA)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:LEE
Last Name:DINKINS
Suffix:
Gender:M
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2171 NW 56TH STREET
Mailing Address - Street 2:HOSANNA COMMUNITY FOUNDATION, INC.
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142
Mailing Address - Country:US
Mailing Address - Phone:305-610-4164
Mailing Address - Fax:305-637-4474
Practice Address - Street 1:2171 NW 56TH ST
Practice Address - Street 2:HOSANNA COMMUNITY FOUNDATION, INC.
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-3011
Practice Address - Country:US
Practice Address - Phone:305-610-4164
Practice Address - Fax:305-637-4474
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No104100000XBehavioral Health & Social Service ProvidersSocial Worker