Provider Demographics
NPI:1730176470
Name:KUFELD, DAWN LAVELLE (MS NCC LPC)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:LAVELLE
Last Name:KUFELD
Suffix:
Gender:F
Credentials:MS NCC LPC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:LAVELLE
Other - Last Name:CARRUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9600 N TALL TREE DR
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401
Mailing Address - Country:US
Mailing Address - Phone:928-263-0750
Mailing Address - Fax:
Practice Address - Street 1:9600 N TALL TREE DR
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401
Practice Address - Country:US
Practice Address - Phone:928-718-4800
Practice Address - Fax:928-757-3256
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC1907101Y00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor