Provider Demographics
NPI:1669147229
Name:ATCHISON, DHARTI (LCSW)
Entity type:Individual
Prefix:
First Name:DHARTI
Middle Name:
Last Name:ATCHISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 WILLIAMS DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-1242
Mailing Address - Country:US
Mailing Address - Phone:713-423-9870
Mailing Address - Fax:
Practice Address - Street 1:2320 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-1242
Practice Address - Country:US
Practice Address - Phone:713-423-9870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-14
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW17939101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor