Healthcare Provider Details

I. General information

NPI: 1891466991
Provider Name (Legal Business Name): BRIANNA DAWKINS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 LINCOLN AVE APT 639
ORANGE NJ
07050-3086
US

IV. Provider business mailing address

51 LINCOLN AVE APT 639
ORANGE NJ
07050-3086
US

V. Phone/Fax

Practice location:
  • Phone: 845-405-2688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111724
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: