Provider Demographics
NPI:1184286700
Name:DAWSON, JOHN (LLMSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:DAWSON
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 WILTSIE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48450-9218
Mailing Address - Country:US
Mailing Address - Phone:810-359-5448
Mailing Address - Fax:
Practice Address - Street 1:51 N HOWARD AVE
Practice Address - Street 2:
Practice Address - City:CROSWELL
Practice Address - State:MI
Practice Address - Zip Code:48422-1282
Practice Address - Country:US
Practice Address - Phone:810-679-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011049281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical