Basic Information
| Provider Information | |||||||||
| NPI: | 1902546286 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOCKERY | ||||||||
| FirstName: | SAMUEL | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW-A, LCAS-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 5TH AVE E | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287924377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286924289 | ||||||||
| FaxNumber: | 8286961794 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 VIEW POINTE DR | ||||||||
| Address2: | |||||||||
| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289068621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286313973 | ||||||||
| FaxNumber: | 8286319280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2022 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | LCAS-28270 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | P017198 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.