Healthcare Provider Details

I. General information

NPI: 1699313403
Provider Name (Legal Business Name): DAWN SWANTKO LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAWN WHETSTONE/GAUGH LCMHC, LCASA

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 SOUTHPOINT LN
NEW LONDON NC
28127-9155
US

IV. Provider business mailing address

2123 SOUTHPOINT LN
NEW LONDON NC
28127-9155
US

V. Phone/Fax

Practice location:
  • Phone: 919-749-2878
  • Fax:
Mailing address:
  • Phone: 704-322-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number21157
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21157
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number25212
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: