Provider Demographics
NPI:1174022529
Name:CLEVELAND, DAVID W (MSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-6903
Mailing Address - Country:US
Mailing Address - Phone:334-702-7222
Mailing Address - Fax:334-702-1944
Practice Address - Street 1:101 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-6903
Practice Address - Country:US
Practice Address - Phone:334-702-7222
Practice Address - Fax:334-702-1944
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker