Provider Demographics
NPI:1225056344
Name:DUBYAK, MAUREEN MC DEVITT (LISW)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:MC DEVITT
Last Name:DUBYAK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MRS
Other - First Name:MAUREEN
Other - Middle Name:MCDEVITT
Other - Last Name:DUBYAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:10000 BRECKSVILLE RD.
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44140
Mailing Address - Country:US
Mailing Address - Phone:216-752-0242
Mailing Address - Fax:440-746-2104
Practice Address - Street 1:10000 BRECKSVILLE RD.
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141
Practice Address - Country:US
Practice Address - Phone:440-526-3030
Practice Address - Fax:440-746-2104
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00083751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI0008375OtherLICENSE