Provider Demographics
NPI:1508740598
Name:DOCKERY, ANDREW PAUL (LCMHCA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PAUL
Last Name:DOCKERY
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 1:506 N BUCHANAN BLVD APT 9
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1758
Mailing Address - Country:US
Mailing Address - Phone:984-329-6094
Mailing Address - Fax:
Practice Address - Street 1:202 MILLSTONE DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8776
Practice Address - Country:US
Practice Address - Phone:984-310-8667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health