Provider Demographics
NPI:1467711994
Name:COLBERT-DAWSON, RAQUEL D (LPC)
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:D
Last Name:COLBERT-DAWSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 W 56TH ST N
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74126-2118
Mailing Address - Country:US
Mailing Address - Phone:918-378-9039
Mailing Address - Fax:
Practice Address - Street 1:4853 S SHERIDAN RD STE 611
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5760
Practice Address - Country:US
Practice Address - Phone:918-270-2413
Practice Address - Fax:844-273-7546
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79590101YM0800X
OK5309101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health