Provider Demographics
NPI:1003108986
Name:LIPHART, DAWN S (LMHC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:S
Last Name:LIPHART
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8212 WHITE FALLS BLVD UNIT 105
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8507
Mailing Address - Country:US
Mailing Address - Phone:904-651-1665
Mailing Address - Fax:
Practice Address - Street 1:11265 ALUMNI WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-6685
Practice Address - Country:US
Practice Address - Phone:904-398-2020
Practice Address - Fax:904-724-2172
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8414101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health