Individual provider Active NPI

Sean Addison Dawson, LPA, LCAS

  • Psychologist
  • Charlotte, NC
National Provider Identifier
1568010049
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5575 Issued in NC
Practice address
5821 Fairview Rd Ste 106
Charlotte, NC 28209-3649
Phone
(704) 826-3550
Fax
(704) 538-4135
NPI assigned
Aug 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-25206 NC
Psychologist 103T00000X 5575 NC Primary

Addresses

Primary practice location

5821 Fairview Rd Ste 106
Charlotte, NC 28209-3649

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (919) 237-1337

Other practice location 1

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231209000310 NC Practitioner - Psychologist Billing Independently 6901255421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of North Carolina at Chapel Hill School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

5821 Fairview Rd
Suite 106
Charlotte, NC 28209-3649
Phone (704) 826-3550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-25206NCMDAddiction (Substance Use Disorder) Counselor
5575NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

5821 Fairview Rd
Ste 106
Charlotte, NC 28209
Phone (704) 826-3500

4705 University Dr
Bldg 700
Durham, NC 27707
Phone (919) 237-1337

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1568010049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337",
            "fax_number": "919-237-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 FAIRVIEW RD STE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093649",
            "telephone_number": "704-826-3550",
            "fax_number": "704-538-4135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Shipyard Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284126431",
            "country_code": "US",
            "telephone_number": "910-343-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "SEAN",
        "middle_name": "ADDISON",
        "name_prefix": "Mr.",
        "credential": "LPA, LCAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-28",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-25206",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.