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NPI Code Detail

MEDICARE: SELENA DAWSON LPCC, LADC

MEDICARE: SELENA DAWSON LPCC, LADC
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) Counselor305487MN
2101YM0800XMental Health Counselor3662MN

General Provider Information

NPI Number : 1326897323
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELENA DAWSON LPCC, LADC
Provider Business Mailing Address
First Line : 9224 WOODHALL BAY N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-1625
Country : US
Telephone Number : 612-432-5131
Fax Number :
Provider Business Practice Location Address
First Line : 8590 EDINBURGH CENTER DR
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-3723
Country : US
Telephone Number : 612-432-5131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2024
Last Update Date : 05/14/2024

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Directions to “ SELENA DAWSON LPCC, LADC” Practice Location

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