Provider Demographics
NPI:1669000279
Name:AKASSON, DORI OXENDINE
Entity Type:Individual
Prefix:
First Name:DORI
Middle Name:OXENDINE
Last Name:AKASSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DORI
Other - Middle Name:BETH
Other - Last Name:OXENDINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LCAS
Mailing Address - Street 1:1706 WAYNE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2240
Mailing Address - Country:US
Mailing Address - Phone:919-734-6676
Mailing Address - Fax:919-238-7919
Practice Address - Street 1:1706 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2240
Practice Address - Country:US
Practice Address - Phone:919-734-6676
Practice Address - Fax:919-238-7919
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0144831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty