Provider Demographics
NPI:1295762193
Name:BIRK, DAWN MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:BIRK
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0732
Mailing Address - Country:US
Mailing Address - Phone:406-252-0011
Mailing Address - Fax:406-256-7074
Practice Address - Street 1:1018 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0732
Practice Address - Country:US
Practice Address - Phone:406-252-0011
Practice Address - Fax:406-245-7074
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT266103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000490501Medicaid
MT000050059Medicare ID - Type UnspecifiedPSYCHOLOGIST