Provider Demographics
NPI:1760782494
Name:NUSS, DAWN MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:NUSS
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 1:13788 630TH ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:MN
Mailing Address - Zip Code:55924-4614
Mailing Address - Country:US
Mailing Address - Phone:507-528-2851
Mailing Address - Fax:
Practice Address - Street 1:13788 630TH ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:MN
Practice Address - Zip Code:55924-4614
Practice Address - Country:US
Practice Address - Phone:507-528-2851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLPC00633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health