Provider Demographics
NPI:1679143804
Name:LAWSON, DYLAN JAY (MHC-LP)
Entity type:Individual
Prefix:MR
First Name:DYLAN
Middle Name:JAY
Last Name:LAWSON
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 6TH ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-7219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:875 6TH AVENUE
Practice Address - Street 2:SUITE 2300
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1000
Practice Address - Country:US
Practice Address - Phone:201-417-5131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health