Provider Demographics
NPI:1316120470
Name:GESUALDI, DAWN M (MS, LCMHCA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:GESUALDI
Suffix:
Gender:F
Credentials:MS, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 MERCHANTS CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-5279
Mailing Address - Country:US
Mailing Address - Phone:910-941-0071
Mailing Address - Fax:910-338-0129
Practice Address - Street 1:144 MERCHANTS CIR STE 100
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-5279
Practice Address - Country:US
Practice Address - Phone:910-941-0071
Practice Address - Fax:910-338-0129
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health