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General NPI Number Information
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NPI Number | 1013307586
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Entity Type | Organization
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Legal Business Name | DAWN M KUSINSKI
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 863 CENTER CT UNIT A
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City | SHOREWOOD
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State | IL
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Zip | 60404-8512
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Country | US
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Telephone | 505-412-9185
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Fax |
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Provider Business Mailing Address
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Address Line | 863 CENTER CT UNIT A
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City | SHOREWOOD
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State | IL
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Zip | 60404-8512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | DAWN KUSINSKI
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Credential | LPC
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Telephone | 505-412-9185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.009423
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License Number State | IL
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