| Richard Lornal Dodge, PHD CADCII ICRE | |
|
3407 Shamrock Ct, Gautier, MS 39553 | |
| (228) 497-0690 | |
| (228) 497-1363 |
| Full Name | Richard Lornal Dodge |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 3407 Shamrock Ct, Gautier, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639114663 | NPI | - | NPPES |
| 00018214 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | A8424202 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Lornal Dodge, PHD CADCII ICRE 3407 Shamprock Ct, Gautier, MS 39553 Ph: (228) 497-0690 | Richard Lornal Dodge, PHD CADCII ICRE 3407 Shamrock Ct, Gautier, MS 39553 Ph: (228) 497-0690 |
Ms. Peggy Lynn Fendley, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 Fax: 228-497-1363 | |
Mrs. Jodi Leighann Carlisle, MS COUNSELING PSYCHO Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 Fax: 228-497-1363 | |
Valencia Henderson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 | |
Tiffany Alycia Baker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 | |
Sara Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 | |
Debra Ann Dionne, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 | |
Cheryl Murray, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 |