Healthcare Provider Details

I. General information

NPI: 1194530949
Provider Name (Legal Business Name): DAWN MAYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 E WEBSTER PL STE 203
MILWAUKEE WI
53211-4257
US

IV. Provider business mailing address

13330 CRESTWOOD CT
NEW BERLIN WI
53151-4700
US

V. Phone/Fax

Practice location:
  • Phone: 414-964-9200
  • Fax:
Mailing address:
  • Phone: 914-217-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11555-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: