Provider Demographics
NPI:1184867129
Name:WIRICK, DAWN (LPC)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:
Last Name:WIRICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:HARSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:750 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1450
Mailing Address - Country:US
Mailing Address - Phone:732-213-8241
Mailing Address - Fax:
Practice Address - Street 1:786 KING GEORGES ROAD
Practice Address - Street 2:
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-1981
Practice Address - Country:US
Practice Address - Phone:732-902-9154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00507800101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor