Provider Demographics
NPI:1467279299
Name:DILLARD, SYMEA LASHAY (CSAC-A, HST, RBT)
Entity type:Individual
Prefix:MS
First Name:SYMEA
Middle Name:LASHAY
Last Name:DILLARD
Suffix:
Gender:F
Credentials:CSAC-A, HST, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 SOUTHGATE SQ
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-3611
Mailing Address - Country:US
Mailing Address - Phone:804-573-9718
Mailing Address - Fax:
Practice Address - Street 1:84 SOUTHGATE SQ
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3611
Practice Address - Country:US
Practice Address - Phone:804-573-9718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0711000649101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)