Healthcare Provider Details

I. General information

NPI: 1750155545
Provider Name (Legal Business Name): THE DAWSON CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 WATERS EDGE DR STE 154
RALEIGH NC
27606-2397
US

IV. Provider business mailing address

2108 W MARILYN CIR
CARY NC
27513-5301
US

V. Phone/Fax

Practice location:
  • Phone: 919-533-4726
  • Fax:
Mailing address:
  • Phone: 919-533-8726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALISA F DAWSON
Title or Position: PSYCHOLOGICAL ASSOCIATE
Credential: LPA
Phone: 919-533-8726