Provider Demographics
NPI:1790237667
Name:DAWSON, ELIZABETH (LMSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 S VALLEY PKWY
Mailing Address - Street 2:APT 6312
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-2025
Mailing Address - Country:US
Mailing Address - Phone:469-771-7660
Mailing Address - Fax:
Practice Address - Street 1:1702 N COLLINS BLVD
Practice Address - Street 2:190
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3566
Practice Address - Country:US
Practice Address - Phone:469-771-7660
Practice Address - Fax:469-248-3635
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61570104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker