Healthcare Provider Details

I. General information

NPI: 1770760159
Provider Name (Legal Business Name): DAWN DEPASQUALE MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6769 STOCKHAM LN
OOLTEWAH TN
37363-1422
US

IV. Provider business mailing address

6769 STOCKHAM LN
OOLTEWAH TN
37363-1422
US

V. Phone/Fax

Practice location:
  • Phone: 508-379-3309
  • Fax: 508-622-5690
Mailing address:
  • Phone: 774-955-7731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01353
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6468
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC016583
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8637
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: