=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316561459
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SC DAWSON CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2020
-----------------------------------------------------
Last Update Date | 09/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2620 N WALNUT ST STE 905
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47404-2008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-269-2433
-----------------------------------------------------
Fax | 812-618-0822
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2620 N WALNUT ST STE 905
-----------------------------------------------------
City | BLOOMINGTON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47404-2008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-269-2433
-----------------------------------------------------
Fax | 812-618-0822
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SPENCER CHARLES DAWSON
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 812-269-2433
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------