MEDICARE: DAWN MARSH LPC, CAC 3

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor	0005708	CO

General Provider Information

NPI Number	:	1679751242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN MARSH LPC, CAC 3

Provider Business Mailing Address
First Line	:	6638 W OTTAWA AVE # 145
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-4562
Country	:	US
Telephone Number	:	720-765-9590
Fax Number	:	303-484-2441

Provider Business Practice Location Address
First Line	:	6638 W OTTAWA AVE # 145
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-4562
Country	:	US
Telephone Number	:	720-765-9590
Fax Number	:	303-484-2441

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

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	04/03/2019

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