Provider Demographics
NPI:1255137667
Name:DODD, DEXTER (MS, MDIV, BA,)
Entity type:Individual
Prefix:DR
First Name:DEXTER
Middle Name:
Last Name:DODD
Suffix:
Gender:M
Credentials:MS, MDIV, BA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 CATOR AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-1227
Mailing Address - Country:US
Mailing Address - Phone:443-885-0491
Mailing Address - Fax:
Practice Address - Street 1:825 CATOR AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-1227
Practice Address - Country:US
Practice Address - Phone:443-885-0491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YP2500X, 101Y00000X
MDLCA3520101YA0400X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral