Provider Demographics
NPI:1740236462
Name:DAWKINS, CAROLYN G (LCSWC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:G
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:MRS
Other - First Name:CAROLYN
Other - Middle Name:D
Other - Last Name:SAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9006 WOODYARD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4206
Mailing Address - Country:US
Mailing Address - Phone:301-856-3636
Mailing Address - Fax:301-856-3633
Practice Address - Street 1:9006 WOODYARD RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4206
Practice Address - Country:US
Practice Address - Phone:301-856-3636
Practice Address - Fax:301-856-3633
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD099301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408609100Medicaid
MD454CDIOtherCAREFIRST BC/BS
MD408609100Medicaid