Provider Demographics
NPI:1407433725
Name:DODSON, TIMOTHY (LCMHCA)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:DODSON
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 LYNN TOWNES CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4096
Mailing Address - Country:US
Mailing Address - Phone:919-710-6752
Mailing Address - Fax:
Practice Address - Street 1:148 WIND CHIME CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6581
Practice Address - Country:US
Practice Address - Phone:919-228-8631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2025-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21470101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health