Active NPI
Teddy Dawson, LPC
- Professional Counselor
- Ludington, MI
National Provider Identifier
1477064285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401016234
- Practice address
- 920 Diana St
Ludington, MI 49431-1987 - Phone
- (231) 845-6294
- Fax
- (231) 845-7095
- NPI assigned
- Oct 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401016234 | MI | Primary |
Addresses
Primary practice location
920 Diana St
Ludington, MI 49431-1987
Mailing address
920 Diana St
Ludington, MI 49431-1987
Phone (231) 845-6294
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401016234 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602460800000",
"number": "1477064285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 DIANA ST",
"city": "LUDINGTON",
"state": "MI",
"postal_code": "494311987",
"telephone_number": "231-845-6294",
"fax_number": "231-845-7095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 DIANA ST",
"city": "LUDINGTON",
"state": "MI",
"postal_code": "494311987",
"telephone_number": "231-845-6294",
"fax_number": "231-845-7095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "TEDDY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-19",
"last_updated": "2020-10-12",
"certification_date": "2020-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401016234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ludington, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.