Provider Demographics
NPI:1861899643
Name:DAWSON, DENISE SHAVON (LCSW, LCAS)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:SHAVON
Last Name:DAWSON
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756-402 CL TART CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-3149
Mailing Address - Country:US
Mailing Address - Phone:919-593-3340
Mailing Address - Fax:919-550-2397
Practice Address - Street 1:3201 YORKTOWN AVE STE 117D
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1474
Practice Address - Country:US
Practice Address - Phone:919-593-3340
Practice Address - Fax:919-550-2397
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-22
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2343101YA0400X
NCC008795101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health