Provider Demographics
NPI:1497411987
Name:GORLITSKY, DAWN STARR (PSYD, ABSNP)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:STARR
Last Name:GORLITSKY
Suffix:
Gender:F
Credentials:PSYD, ABSNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-2175
Mailing Address - Country:US
Mailing Address - Phone:845-216-3989
Mailing Address - Fax:
Practice Address - Street 1:27 WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-2175
Practice Address - Country:US
Practice Address - Phone:845-216-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013225252Y00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No252Y00000XAgenciesEarly Intervention Provider Agency