Provider Demographics
NPI:1992375364
Name:SARGENT, DAWN MARGARET
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARGARET
Last Name:SARGENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 PORTER ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-2939
Mailing Address - Country:US
Mailing Address - Phone:203-394-1988
Mailing Address - Fax:
Practice Address - Street 1:1653 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-1525
Practice Address - Country:US
Practice Address - Phone:203-371-8200
Practice Address - Fax:203-371-8200
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4965OtherPROFESSIONAL COUNSELOR