Provider Demographics
NPI:1538118864
Name:HOSEY, DAWN M (LPC, LICENSED PROFES)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:HOSEY
Suffix:
Gender:F
Credentials:LPC, LICENSED PROFES
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:LEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:P.O. BOX 801
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39566-0801
Mailing Address - Country:US
Mailing Address - Phone:601-329-9762
Mailing Address - Fax:228-222-2960
Practice Address - Street 1:2112 BIENVILLE BOULEVARD, SUITE O-1
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564
Practice Address - Country:US
Practice Address - Phone:601-329-9762
Practice Address - Fax:228-222-2960
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0619101YP2500X
0619101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS11587728OtherCAQH