Provider Demographics
NPI:1942675012
Name:NAVARRO, DOMINIQUE (LCPC, LPCMH)
Entity Type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:LCPC, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29315 ERICKSON DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8651
Mailing Address - Country:US
Mailing Address - Phone:410-758-2211
Mailing Address - Fax:
Practice Address - Street 1:29315 ERICKSON DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-8651
Practice Address - Country:US
Practice Address - Phone:410-690-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8265101YM0800X
DEPC-0000847101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health