Provider Demographics
NPI:1831374149
Name:DOLLENS, ANGELA DAWN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DAWN
Last Name:DOLLENS
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 1:3909 S WILSON RD
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-8944
Mailing Address - Country:US
Mailing Address - Phone:270-351-9444
Mailing Address - Fax:270-351-0400
Practice Address - Street 1:3909 S WILSON RD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-8944
Practice Address - Country:US
Practice Address - Phone:270-351-9444
Practice Address - Fax:270-351-0400
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical