Provider Demographics
NPI:1932327889
Name:DAWSON, EUGENE (MSW LSW)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:
Last Name:DAWSON
Suffix:
Gender:M
Credentials:MSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20280 BLACKFOOT AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2413
Mailing Address - Country:US
Mailing Address - Phone:216-486-4420
Mailing Address - Fax:
Practice Address - Street 1:333 BABBITT RD STE 242
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1636
Practice Address - Country:US
Practice Address - Phone:440-260-6430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31371104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker