Provider Demographics
NPI:1447590781
Name:DAWSTON, LAKITA
Entity Type:Individual
Prefix:
First Name:LAKITA
Middle Name:
Last Name:DAWSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAKITA
Other - Middle Name:
Other - Last Name:QUARLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3475 BUCHANAN RD SE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323-0459
Mailing Address - Country:US
Mailing Address - Phone:423-579-2796
Mailing Address - Fax:
Practice Address - Street 1:3505 ADKISSON DR NW STE 163
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-6807
Practice Address - Country:US
Practice Address - Phone:423-339-5590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-23
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 171M00000X, 251S00000X, 175T00000X, 251B00000X, 347C00000X, 251E00000X, 385H00000X
TN1000000027218251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No251B00000XAgenciesCase Management
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care