Provider Demographics
NPI:1841699006
Name:SANDOVAL, DAWN MARIE (MA,LPC, CAADC,NCC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:MA,LPC, CAADC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23995 NOVI RD STE C101
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5439
Mailing Address - Country:US
Mailing Address - Phone:517-367-0670
Mailing Address - Fax:517-367-0681
Practice Address - Street 1:23995 NOVI RD STE C101
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375
Practice Address - Country:US
Practice Address - Phone:517-367-0670
Practice Address - Fax:517-367-0681
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014335101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor