Provider Demographics
NPI:1568010049
Name:DAWSON, SEAN ADDISON (LPA, LCAS)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:ADDISON
Last Name:DAWSON
Suffix:
Gender:M
Credentials:LPA, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 UNIVERSITY DR BLDG 700
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3489
Mailing Address - Country:US
Mailing Address - Phone:919-237-1337
Mailing Address - Fax:919-237-1625
Practice Address - Street 1:5821 FAIRVIEW RD STE 106
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3649
Practice Address - Country:US
Practice Address - Phone:704-826-3550
Practice Address - Fax:704-538-4135
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-25206101YA0400X
NC5575103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)