Healthcare Provider Details

I. General information

NPI: 1760757413
Provider Name (Legal Business Name): DANIEL DAWSON APRN, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 BOARDMAN CANFIELD RD
YOUNGSTOWN OH
44512-4236
US

IV. Provider business mailing address

833 BOARDMAN CANFIELD RD
YOUNGSTOWN OH
44512
US

V. Phone/Fax

Practice location:
  • Phone: 330-953-1964
  • Fax:
Mailing address:
  • Phone: 330-953-1964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.021132
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1100541
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.416107
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: