=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639459977
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAWN MARIE MACRI LMHC, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2011
-----------------------------------------------------
Last Update Date | 02/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 ELK RIDGE RD
-----------------------------------------------------
City | CALIFON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07830-4112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-403-7573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 ELK RIDGE RD
-----------------------------------------------------
City | CALIFON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07830-4112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-403-7573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 37PC00658400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MH5582
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | C7389
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 81053
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------