Provider Demographics
NPI:1861577926
Name:GADEN, DAWN MARIE (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:GADEN
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20730 BETSIE HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:INTERLOCHEN
Mailing Address - State:MI
Mailing Address - Zip Code:49643-9318
Mailing Address - Country:US
Mailing Address - Phone:810-623-7375
Mailing Address - Fax:
Practice Address - Street 1:20730 BETSIE HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:INTERLOCHEN
Practice Address - State:MI
Practice Address - Zip Code:49643-9318
Practice Address - Country:US
Practice Address - Phone:810-623-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008212101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1861577926Medicaid