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Provider Information for 1902866676


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RICHARD A DAWSON LCSW, LADC


Sex: Male

NPI: 1902866676
Last Updated: 2010-02-04
Certification Date:

Details

NameValue
NPI1902866676
Enumeration Date2006-03-25
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 575 E PLUMB LN
RENO, NV 89502-3540
United States

Phone: 775-329-0623 | Fax:775-337-2971
 
Primary Practice Address 575 E PLUMB LN
RENO, NV 89502-3540
United States

Phone: 775-329-0623 | Fax:775-337-2971
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNV100508211
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)NV953-L
Yes 1041C0700X - Social Worker - ClinicalNV4222-C