Provider Demographics
NPI:1245857713
Name:DICKERSON, JUNE FAITH (MA, LCPC)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:FAITH
Last Name:DICKERSON
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 PAULA CT
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-5739
Mailing Address - Country:US
Mailing Address - Phone:202-251-2211
Mailing Address - Fax:
Practice Address - Street 1:5869 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20746-4548
Practice Address - Country:US
Practice Address - Phone:301-433-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10552101YM0800X
MDLC12755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health