Provider Demographics
NPI:1790431237
Name:DAWSON, DARRIAN D (LCSW)
Entity Type:Individual
Prefix:
First Name:DARRIAN
Middle Name:D
Last Name:DAWSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58266 PEGGY LEE DR
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-5634
Mailing Address - Country:US
Mailing Address - Phone:985-320-7085
Mailing Address - Fax:
Practice Address - Street 1:58266 PEGGY LEE DR
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-5634
Practice Address - Country:US
Practice Address - Phone:985-320-7085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX640121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical