Provider Demographics
NPI:1588061147
Name:BELLE-GADDY, DAWN
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BELLE-GADDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:BELLE-GADDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2189 SPRING BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:TAR HEEL
Mailing Address - State:NC
Mailing Address - Zip Code:28392-8550
Mailing Address - Country:US
Mailing Address - Phone:910-549-8149
Mailing Address - Fax:
Practice Address - Street 1:2189 SPRING BRANCH RD
Practice Address - Street 2:
Practice Address - City:TAR HEEL
Practice Address - State:NC
Practice Address - Zip Code:28392-8550
Practice Address - Country:US
Practice Address - Phone:910-549-8149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0091551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical