Healthcare Provider Details

I. General information

NPI: 1386551562
Provider Name (Legal Business Name): DAWSON CRIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N MUR LEN RD
OLATHE KS
66062-5431
US

IV. Provider business mailing address

780 S MULBERRY ST
GARDNER KS
66030-1675
US

V. Phone/Fax

Practice location:
  • Phone: 913-210-0636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05477
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: