Provider Demographics
NPI:1487146106
Name:DIKAHA, DIERRE A
Entity type:Individual
Prefix:MR
First Name:DIERRE
Middle Name:A
Last Name:DIKAHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DIERRE
Other - Middle Name:A
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, MFT, CDC
Mailing Address - Street 1:3106 ALABAMA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-3010
Mailing Address - Country:US
Mailing Address - Phone:704-301-5436
Mailing Address - Fax:
Practice Address - Street 1:1427 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020
Practice Address - Country:US
Practice Address - Phone:202-836-4841
Practice Address - Fax:202-836-4841
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty