Provider Demographics
NPI:1174956536
Name:DAWSON, SUSAN A (LMHC, CAP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:DAWSON
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:A
Other - Last Name:STAINROD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:321 N DE VILLIERS ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-3890
Mailing Address - Country:US
Mailing Address - Phone:850-512-6574
Mailing Address - Fax:850-466-3959
Practice Address - Street 1:321 N DE VILLIERS ST
Practice Address - Street 2:SUITE 209
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3890
Practice Address - Country:US
Practice Address - Phone:850-512-6574
Practice Address - Fax:850-466-3959
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 5435101YA0400X
FLMH11067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)