Provider Demographics
NPI:1548332695
Name:GURN, DAWN (LPC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:GURN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:DELANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:83 PERRY STREET
Mailing Address - Street 2:SUITE #172
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260
Mailing Address - Country:US
Mailing Address - Phone:860-963-3807
Mailing Address - Fax:
Practice Address - Street 1:112 MAIN STREET
Practice Address - Street 2:SUITE #9
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260
Practice Address - Country:US
Practice Address - Phone:860-963-3807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000375103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
536259OtherVALUE OPTIONS
240000375CT02OtherANTHEM BLUE CROSS BLUE SH
307498OtherMHN