Provider Demographics
NPI:1588828586
Name:DOWDY, MICHAEL D (MA, LSW, LICDC-CS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:DOWDY
Suffix:
Gender:M
Credentials:MA, LSW, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-1707
Mailing Address - Country:US
Mailing Address - Phone:419-771-1050
Mailing Address - Fax:419-771-1051
Practice Address - Street 1:123 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-1707
Practice Address - Country:US
Practice Address - Phone:419-771-1050
Practice Address - Fax:419-771-1051
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.131246101YA0400X
OHS0600902104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)