Provider Demographics
NPI:1487824470
Name:MARPLE GISE, DAWN M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:MARPLE GISE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:MARPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:617B SWEDESFORD RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1530
Mailing Address - Country:US
Mailing Address - Phone:610-251-0821
Mailing Address - Fax:610-251-0822
Practice Address - Street 1:617B SWEDESFORD RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1530
Practice Address - Country:US
Practice Address - Phone:610-251-0821
Practice Address - Fax:610-251-0822
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0144001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA044469Medicare PIN