Provider Demographics
NPI:1902866676
Name:DAWSON, RICHARD A (LCSW, LADC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:DAWSON
Suffix:
Gender:M
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 E PLUMB LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3540
Mailing Address - Country:US
Mailing Address - Phone:775-329-0623
Mailing Address - Fax:775-337-2971
Practice Address - Street 1:575 E PLUMB LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3540
Practice Address - Country:US
Practice Address - Phone:775-329-0623
Practice Address - Fax:775-337-2971
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV953-L101YA0400X
NV4222-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100508211Medicaid
NV100508211Medicaid