Provider Demographics
NPI:1275768954
Name:GROW, DAWN W (LCPC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:W
Last Name:GROW
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4824 ROLLER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-2251
Mailing Address - Country:US
Mailing Address - Phone:443-895-0403
Mailing Address - Fax:
Practice Address - Street 1:11350 MCCORMICK RD STE 1202
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-1002
Practice Address - Country:US
Practice Address - Phone:443-895-0403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-24
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional