MEDICARE: DAWN M GESUALDI MS, LCMHCA

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	A18923	NC

General Provider Information

NPI Number	:	1316120470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN M GESUALDI MS, LCMHCA

Provider Business Mailing Address
First Line	:	144 MERCHANTS CIR STE 100
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-5279
Country	:	US
Telephone Number	:	910-941-0071
Fax Number	:	910-338-0129

Provider Business Practice Location Address
First Line	:	144 MERCHANTS CIR STE 100
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-5279
Country	:	US
Telephone Number	:	910-941-0071
Fax Number	:	910-338-0129

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

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	08/21/2023

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