Provider Demographics
NPI:1295114361
Name:DINKINS, GLADYS FELICIA (EDD,LMFT,NCP,CCP)
Entity type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:FELICIA
Last Name:DINKINS
Suffix:
Gender:F
Credentials:EDD,LMFT,NCP,CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 ROUSER RD
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-5060
Mailing Address - Country:US
Mailing Address - Phone:601-720-1671
Mailing Address - Fax:
Practice Address - Street 1:5360 BLD. C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-4101
Practice Address - Country:US
Practice Address - Phone:601-321-9849
Practice Address - Fax:601-321-9849
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0263106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist