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General NPI Number Information
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NPI Number | 1235228131
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Entity Type | Individual
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Provider Name | DAWN JANELLE BAXLEY LPC
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 15311 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6005
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Country | US
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Telephone | 352-467-6134
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Fax |
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Provider Business Mailing Address
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Address Line | 2995 DREW ST
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City | CLEARWATER
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State | FL
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Zip | 33759-3012
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Country | US
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Telephone | 727-281-9065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 5269
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH24107
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License Number State | FL
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