Provider Demographics
NPI:1144991597
Name:DAWSON, LILLIAN (LCSW)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PHEASANT RUN
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1317
Mailing Address - Country:US
Mailing Address - Phone:732-740-4385
Mailing Address - Fax:
Practice Address - Street 1:100 VILLAGE CT STE 202A
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1565
Practice Address - Country:US
Practice Address - Phone:732-740-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC062359001041C0700X
NJ44SL06672600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical