Healthcare Provider Details

I. General information

NPI: 1326897323
Provider Name (Legal Business Name): SELENA DAWSON LPCC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 SUPERIOR DR NW
ROCHESTER MN
55901-1993
US

IV. Provider business mailing address

3101 SUPERIOR DR NW
ROCHESTER MN
55901-1993
US

V. Phone/Fax

Practice location:
  • Phone: 507-292-1006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number305487
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3662
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: