Provider Demographics
NPI:1184125718
Name:WAMSLEY, DAWN RENEE (LPCC-SUPV, LCDC III)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:RENEE
Last Name:WAMSLEY
Suffix:
Gender:F
Credentials:LPCC-SUPV, LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MORRIS RD
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1363
Mailing Address - Country:US
Mailing Address - Phone:740-474-8874
Mailing Address - Fax:740-477-1463
Practice Address - Street 1:145 MORRIS RD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1363
Practice Address - Country:US
Practice Address - Phone:740-474-8874
Practice Address - Fax:740-477-1463
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC1500048101YP2500X
OHE.1800637-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional