Provider Demographics
NPI:1912103821
Name:ADAMS, DAWN MARIE (M ED, LPC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S MARSHALL ST STE 1
Mailing Address - Street 2:VISION BEHAVIORAL HEALTH SERVICES
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2843
Mailing Address - Country:US
Mailing Address - Phone:336-723-4130
Mailing Address - Fax:336-723-4125
Practice Address - Street 1:100 S MARSHALL ST STE 1
Practice Address - Street 2:VISION BEHAVIORAL HEALTH SERVICES
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2843
Practice Address - Country:US
Practice Address - Phone:336-723-4130
Practice Address - Fax:336-723-4125
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7829101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104626Medicaid
NC6104626OtherHEALTHCHOICE