MEDICARE: ANNIE DAWN HADGKISS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	4185	NC

General Provider Information

NPI Number	:	1174799811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE DAWN HADGKISS LPC

Provider Business Mailing Address
First Line	:	3518 DRAWBRIDGE PKWY
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8432
Country	:	US
Telephone Number	:	336-337-5050
Fax Number	:	336-282-3079

Provider Business Practice Location Address
First Line	:	3518 DRAWBRIDGE PKWY
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-8432
Country	:	US
Telephone Number	:	336-337-5050
Fax Number	:	336-282-3079

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	08/24/2011

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