Phillip Robert Dawalt Jr., CADAC II ADDICTIONS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

25049 Issued in IN

Practice address

1418 Jackson St
Anderson, IN 46016-1619

Phone

(765) 506-7329

NPI assigned

Sep 25, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rob Dawalt Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1487433835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 WESTMINSTER WAY",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460134462",
            "telephone_number": "765-374-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460161619",
            "telephone_number": "765-506-7329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWALT",
        "first_name": "PHILLIP",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "CADAC II ADDICTIONS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "25049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROB",
            "last_name": "DAWALT",
            "credential": "CADAC II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jessica Michelle Davis, OD
• Joyce Ann Davis, APN
• Kathleen Elizabeth Davis, PT, DPT, ATC/L
• Marianne G Davis, D.D.S
• Jonni Davy, DPT
• Emily Day, M.ED, LAT, ATC
• Isabella Maleah Day
• Daybreak & Visiting Nurse Care, LLC
• Joanne P Dean, LCSW
• Megan Christine Deaton, NP

• Addiction (Substance Use Disorder) Counselor in Anderson, IN
• Providers in Anderson, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.