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NPI Code Detail

MEDICARE: DAWN L SLAG LAC LMSW

MEDICARE: DAWN L SLAG LAC LMSW
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1541ND
2104100000XSocial Worker3837ND

General Provider Information

NPI Number : 1255369393
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN L SLAG LAC LMSW
Provider Business Mailing Address
First Line : 1308 ELBOWOOD LN
Second Line :
City : BISMARCK
State : ND
Zip : 58503-5712
Country : US
Telephone Number : 170-175-1826
Fax Number : 701-751-2298
Provider Business Practice Location Address
First Line : 1308 ELBOWOOD LN
Second Line :
City : BISMARCK
State : ND
Zip : 58503-5712
Country : US
Telephone Number : 701-751-8260
Fax Number : 701-751-2298
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2006
Last Update Date : 12/13/2021

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