Provider Demographics
NPI:1669847562
Name:DUTTON, NAKEENYA (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:NAKEENYA
Middle Name:
Last Name:DUTTON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 LYSTRA RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7660
Mailing Address - Country:US
Mailing Address - Phone:919-815-8220
Mailing Address - Fax:
Practice Address - Street 1:3651 LYSTRA RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7660
Practice Address - Country:US
Practice Address - Phone:919-815-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0091571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical