Provider Demographics
NPI:1073276523
Name:HENDRY, DAWN JEANINE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:JEANINE
Last Name:HENDRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:JEANINE
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:12 MOUNTAIN HIGH CT
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-2635
Mailing Address - Country:US
Mailing Address - Phone:720-273-5998
Mailing Address - Fax:
Practice Address - Street 1:12 MOUNTAIN HIGH CT
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-2635
Practice Address - Country:US
Practice Address - Phone:720-273-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO427101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO427OtherDORA LICENSE IN CO