Provider Demographics
NPI:1124725973
Name:MMERE DANE COUNSELING
Entity type:Organization
Organization Name:MMERE DANE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:SHANTE
Authorized Official - Last Name:ADKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-261-9528
Mailing Address - Street 1:4222 FORTUNA CENTER PLZ STE 122
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1515
Mailing Address - Country:US
Mailing Address - Phone:703-261-9528
Mailing Address - Fax:
Practice Address - Street 1:14952 FIG CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-6025
Practice Address - Country:US
Practice Address - Phone:912-980-5489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty