Provider Demographics
NPI:1114145638
Name:WITHERSPOON, DAWN ELAINE (MS, LPC, LCAS)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:ELAINE
Last Name:WITHERSPOON
Suffix:
Gender:F
Credentials:MS, LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-4107
Mailing Address - Country:US
Mailing Address - Phone:704-872-7638
Mailing Address - Fax:704-872-7639
Practice Address - Street 1:503 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4107
Practice Address - Country:US
Practice Address - Phone:704-872-7638
Practice Address - Fax:704-872-7639
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health