Provider Demographics
NPI:1477543007
Name:MCCREARY, DAWN RENE (MS)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:RENE
Last Name:MCCREARY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:RENE
Other - Last Name:MCCREARY-ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3100 BROADWAY ST
Mailing Address - Street 2:SUITE 1104
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2658
Mailing Address - Country:US
Mailing Address - Phone:816-753-3333
Mailing Address - Fax:
Practice Address - Street 1:3100 BROADWAY ST
Practice Address - Street 2:SUITE 1104
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2658
Practice Address - Country:US
Practice Address - Phone:816-753-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001576101YP2500X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist