Provider Demographics
NPI:1366643660
Name:GRAY, DAWN CAROLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:CAROLYN
Last Name:GRAY
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 1:19232 S ASPEN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-9553
Mailing Address - Country:US
Mailing Address - Phone:509-710-7669
Mailing Address - Fax:
Practice Address - Street 1:1313 N ATLANTIC ST STE 2000
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2318
Practice Address - Country:US
Practice Address - Phone:509-363-3404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-282021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical