MEDICARE: DAWN DENISE WARREN MCC LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	006456	CO

General Provider Information

NPI Number	:	1154749109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN DENISE WARREN MCC LPC

Provider Business Mailing Address
First Line	:	6651 GAMBOL QUAIL DR W
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1312
Country	:	US
Telephone Number	:	719-494-9671
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 OFFICE CLUB PT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-5008
Country	:	US
Telephone Number	:	719-494-9671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2014
Last Update Date	:	01/29/2024

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