Casey Jennifer Dawson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9406 Issued in FL

Practice address

3600 Washington St Ste 1005
Hollywood, FL 33021-8216

Phone

(954) 518-5507

Fax

(954) 981-3476

NPI assigned

Jan 16, 2010

Last updated

Mar 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Casey Jennifer Haddad Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1154652030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 WASHINGTON ST STE 1005",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218216",
            "telephone_number": "954-518-5507",
            "fax_number": "954-981-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "CASEY",
        "middle_name": "JENNIFER",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-16",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "9406",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9406",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "FL",
            "license": "9406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdawson154649@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3600 Washington St Ste 1005",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330218216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "HADDAD",
            "middle_name": "JENNIFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Psychologist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.