Provider Demographics
NPI:1518061795
Name:KAY PEARSON, DAWN MARIE (LMHP LADC)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:KAY PEARSON
Suffix:
Gender:F
Credentials:LMHP LADC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:KAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHP
Mailing Address - Street 1:10791 S 72ND ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3402
Mailing Address - Country:US
Mailing Address - Phone:402-714-2357
Mailing Address - Fax:402-292-0144
Practice Address - Street 1:10791 S 72ND ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3402
Practice Address - Country:US
Practice Address - Phone:402-714-2357
Practice Address - Fax:402-292-0144
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE033101Y00000X
NELMHP121101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47083207826Medicaid