Provider Demographics
NPI:1952329120
Name:DAWSON, ALVIN (LPC)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:
Last Name:DAWSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4054 MCKINNEY AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2050
Mailing Address - Country:US
Mailing Address - Phone:214-520-6308
Mailing Address - Fax:
Practice Address - Street 1:4054 MCKINNEY AVE STE 102
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2050
Practice Address - Country:US
Practice Address - Phone:214-520-6308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
84592LOtherBC/BS
9375514OtherPHCS