Provider Demographics
NPI:1982410593
Name:OVERTON, DAWN KENNEDY (LCMHC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:KENNEDY
Last Name:OVERTON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 SPRING ST
Mailing Address - Street 2:ST. JOHNSBURY
Mailing Address - City:ST. JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-1718
Mailing Address - Country:US
Mailing Address - Phone:727-278-0888
Mailing Address - Fax:
Practice Address - Street 1:374 SPRING ST
Practice Address - Street 2:ST. JOHNSBURY
Practice Address - City:ST. JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-1718
Practice Address - Country:US
Practice Address - Phone:727-278-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health