Provider Demographics
NPI:1336654169
Name:BURNS, DAWN MARNIECE (BSW, LSW, CDCA II)
Entity Type:Individual
Prefix:MISS
First Name:DAWN
Middle Name:MARNIECE
Last Name:BURNS
Suffix:
Gender:F
Credentials:BSW, LSW, CDCA II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 NOBLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2161
Mailing Address - Country:US
Mailing Address - Phone:216-795-5066
Mailing Address - Fax:216-795-5495
Practice Address - Street 1:2490 NOBLE RD STE 101
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44121
Practice Address - Country:US
Practice Address - Phone:216-795-5066
Practice Address - Fax:216-795-5495
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH140194101YA0400X
OHS.0800228104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)