Provider Demographics
NPI:1245480656
Name:DOBKEVICH, MICHAEL (LMHC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:DOBKEVICH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-4066
Mailing Address - Country:US
Mailing Address - Phone:360-379-2627
Mailing Address - Fax:
Practice Address - Street 1:1310 ROSE ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-4066
Practice Address - Country:US
Practice Address - Phone:360-379-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009940101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health