Provider Demographics
NPI:1891023669
Name:DYSON, JOI (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JOI
Middle Name:
Last Name:DYSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 MARLORA RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1929
Mailing Address - Country:US
Mailing Address - Phone:410-262-7104
Mailing Address - Fax:410-366-2108
Practice Address - Street 1:2510 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-4760
Practice Address - Country:US
Practice Address - Phone:410-558-0032
Practice Address - Fax:410-366-2108
Is Sole Proprietor?:No
Enumeration Date:2009-12-06
Last Update Date:2009-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD147411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical