Provider Demographics
NPI:1548372279
Name:BRENNAN, DAWN (LCPC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 E. 2ND. ST. #302
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937
Mailing Address - Country:US
Mailing Address - Phone:406-407-0684
Mailing Address - Fax:888-437-8696
Practice Address - Street 1:144 E. 2ND. ST. #302
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937
Practice Address - Country:US
Practice Address - Phone:406-407-0684
Practice Address - Fax:888-437-8696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWPLCPCLIC747101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional