MEDICARE: DAWN DILLON COUNSELING AND CONSULTING, PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1205454410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAWN DILLON COUNSELING AND CONSULTING, PLLC

Provider Business Mailing Address
First Line	:	3100 W 7TH ST APT 619
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2797
Country	:	US
Telephone Number	:	817-613-6803
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 S HULEN ST STE 450
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-4910
Country	:	US
Telephone Number	:	817-613-6803
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. DAWN ANN DILLON
Credential	:	LPC
Telephone Number	:	817-613-6803

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	07/14/2020

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