Provider Demographics
NPI:1538424809
Name:DAWSON, SHAUNA NICOLE
Entity type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:NICOLE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHAUNA
Other - Middle Name:NICOLE
Other - Last Name:DAWSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 CAMBRIDGE ST FL 14
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2509
Mailing Address - Country:US
Mailing Address - Phone:617-212-5090
Mailing Address - Fax:
Practice Address - Street 1:100 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2509
Practice Address - Country:US
Practice Address - Phone:617-212-5090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS83106103101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor