Provider Demographics
NPI:1235110917
Name:DAWSON, DEBORAH (PHD LISW)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PHD LISW
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:DAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD LISW
Mailing Address - Street 1:PO BOX 24242
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-0242
Mailing Address - Country:US
Mailing Address - Phone:216-839-2273
Mailing Address - Fax:216-839-2273
Practice Address - Street 1:9172 BYRON AVE
Practice Address - Street 2:
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-3137
Practice Address - Country:US
Practice Address - Phone:216-469-2857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0004448104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDASW12042Medicare ID - Type Unspecified