Provider Demographics
NPI:1265661201
Name:BASS, DAWN L (BSW MA LPC NBCC)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:L
Last Name:BASS
Suffix:
Gender:F
Credentials:BSW MA LPC NBCC
Other - Prefix:MRS
Other - First Name:DAWN
Other - Middle Name:L
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW MA LPC NBCC
Mailing Address - Street 1:109 N COURT SQ
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-5554
Mailing Address - Country:US
Mailing Address - Phone:910-272-9356
Mailing Address - Fax:910-735-1945
Practice Address - Street 1:109 N COURT SQ
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5554
Practice Address - Country:US
Practice Address - Phone:910-272-9356
Practice Address - Fax:910-735-1945
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7396101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional