Healthcare Provider Details

I. General information

NPI: 1063522175
Provider Name (Legal Business Name): DAWN WEBB WELCH MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN LASHEA WEBB MSW, LCSW

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/27/2022
Certification Date: 05/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 SAINT DAVID STREET
HALIFAX NC
27839
US

IV. Provider business mailing address

PO BOX 245
HALIFAX NC
27839-0245
US

V. Phone/Fax

Practice location:
  • Phone: 252-532-0057
  • Fax:
Mailing address:
  • Phone: 252-532-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904007026
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004837
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: