Provider Demographics
NPI:1912558164
Name:DREAMWALKER LM.S.W. PLLC
Entity Type:Organization
Organization Name:DREAMWALKER LM.S.W. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:585-507-9250
Mailing Address - Street 1:11 ASTON VILLA
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-9820
Mailing Address - Country:US
Mailing Address - Phone:585-507-9250
Mailing Address - Fax:585-571-4749
Practice Address - Street 1:11 ASTON VILLA
Practice Address - Street 2:
Practice Address - City:NORTH CHILI
Practice Address - State:NY
Practice Address - Zip Code:14514-9820
Practice Address - Country:US
Practice Address - Phone:585-507-9250
Practice Address - Fax:585-571-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty