Healthcare Provider Details

I. General information

NPI: 1639582802
Provider Name (Legal Business Name): DAWN SCOTT LPCC, LMFT, LD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 03/02/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 MEDINA RD STE 2
MEDINA OH
44256-5333
US

IV. Provider business mailing address

22001 FAIRMOUNT BLVD
SHAKER HTS OH
44118-4819
US

V. Phone/Fax

Practice location:
  • Phone: 330-241-4444
  • Fax:
Mailing address:
  • Phone: 330-241-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2002949
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM.2100156
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2303369
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: