=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669832713
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAWN HARDWICK LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2016
-----------------------------------------------------
Last Update Date | 10/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 655 7TH ST BLDG 700
-----------------------------------------------------
City | ROBINS AFB
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31098-2227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-327-7850
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 655 7TH ST BLDG 700
-----------------------------------------------------
City | ROBINS AFB
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31098-2227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-683-1460
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 4890
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 6601
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------