Provider Demographics
NPI:1730446683
Name:SHEA-FRICK, DAWN (LCMHC, LCAS)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SHEA-FRICK
Suffix:
Gender:F
Credentials:LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5135 MORGANTON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1525
Mailing Address - Country:US
Mailing Address - Phone:910-797-4404
Mailing Address - Fax:910-240-9783
Practice Address - Street 1:5135 MORGANTON RD STE 103
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1525
Practice Address - Country:US
Practice Address - Phone:910-797-4404
Practice Address - Fax:910-240-9783
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-17
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9178101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional