Provider Demographics
NPI:1124490180
Name:EADEN, DAWN ROCHELLE (MED, LPC, LCDCI)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:ROCHELLE
Last Name:EADEN
Suffix:
Gender:F
Credentials:MED, LPC, LCDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7337 HOWTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-4307
Mailing Address - Country:US
Mailing Address - Phone:713-562-6110
Mailing Address - Fax:
Practice Address - Street 1:2656 S LOOP W
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2664
Practice Address - Country:US
Practice Address - Phone:832-945-1392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74523101YP2500X
GALPC007519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional