Provider Demographics
NPI:1245846856
Name:RICHARD, DAWN MARIE (TCADC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:RICHARD
Suffix:
Gender:
Credentials:TCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 33RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4646
Mailing Address - Country:US
Mailing Address - Phone:319-560-5523
Mailing Address - Fax:
Practice Address - Street 1:260 33RD AVE SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4646
Practice Address - Country:US
Practice Address - Phone:319-560-5523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT18064101YA0400X
IA105536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)