Provider Demographics
NPI:1932297769
Name:WHITEHEAD, DAWN M II
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:WHITEHEAD
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 MENDON RD STE E
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-5436
Mailing Address - Country:US
Mailing Address - Phone:401-864-5351
Mailing Address - Fax:
Practice Address - Street 1:895 MENDON RD STE E
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-5436
Practice Address - Country:US
Practice Address - Phone:401-864-5351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI101YM0800X
RIMHC00304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0000031809OtherBLUE CROSS
RIDD56325Medicaid
RIDD56325Medicaid