Provider Demographics
NPI:1235288804
Name:DAWSON, CAROL S (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:S
Last Name:DAWSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LOOP 304 EAST
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:TX
Mailing Address - Zip Code:75835-1100
Mailing Address - Country:US
Mailing Address - Phone:936-546-3862
Mailing Address - Fax:936-546-3816
Practice Address - Street 1:1100 LOOP 304 EAST
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-1100
Practice Address - Country:US
Practice Address - Phone:936-546-3862
Practice Address - Fax:936-546-3816
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX02252OtherTX STATE BOARD OF SOCIAL