Healthcare Provider Details

I. General information

NPI: 1629203161
Provider Name (Legal Business Name): DAWN WOODARD MSSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 UNDERWOOD AVE
MONTELLO WI
53949-9248
US

IV. Provider business mailing address

617 PAUQUETTE PINES LN
POYNETTE WI
53955-8721
US

V. Phone/Fax

Practice location:
  • Phone: 608-297-3118
  • Fax: 608-297-8718
Mailing address:
  • Phone: 608-516-8422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4053-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: