Provider Demographics
NPI:1811097769
Name:EDWARDS, DAWN F (LCDC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:F
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:F
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 S ALAMEDA
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404
Mailing Address - Country:US
Mailing Address - Phone:361-887-7070
Mailing Address - Fax:361-888-9250
Practice Address - Street 1:619 LIVE OAK
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382
Practice Address - Country:US
Practice Address - Phone:361-887-7070
Practice Address - Fax:361-888-9250
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9163101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)