Provider Demographics
NPI:1023318094
Name:HUTTON, DORCAS K (MS, LCPC, NCC)
Entity type:Individual
Prefix:
First Name:DORCAS
Middle Name:K
Last Name:HUTTON
Suffix:
Gender:F
Credentials:MS, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 UPNOR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3326
Mailing Address - Country:US
Mailing Address - Phone:443-418-1008
Mailing Address - Fax:
Practice Address - Street 1:1122 KENILWORTH DR
Practice Address - Street 2:SUITE 109
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2139
Practice Address - Country:US
Practice Address - Phone:443-418-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4669101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional