Provider Demographics
NPI:1316561459
Name:SC DAWSON CONSULTING
Entity Type:Organization
Organization Name:SC DAWSON CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:812-269-2433
Mailing Address - Street 1:2804 N BLUE SLOPES DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-1022
Mailing Address - Country:US
Mailing Address - Phone:812-269-2433
Mailing Address - Fax:812-618-0822
Practice Address - Street 1:2804 N BLUE SLOPES DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-1022
Practice Address - Country:US
Practice Address - Phone:812-269-2433
Practice Address - Fax:812-618-0822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1669094025OtherNPPES