Provider Demographics
NPI:1023056116
Name:ARRAHEEM, MAWAUSI SSABAH (MSW, CSW, LICDC,LPN)
Entity type:Individual
Prefix:MS
First Name:MAWAUSI
Middle Name:SSABAH
Last Name:ARRAHEEM
Suffix:
Gender:F
Credentials:MSW, CSW, LICDC,LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 ACADEMY PL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-4718
Mailing Address - Country:US
Mailing Address - Phone:927-279-9167
Mailing Address - Fax:937-279-9671
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-268-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010809601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801080960OtherCLICAL SOCIAL WORKER
OH045854OtherLPN
OH021203OtherCHEMICAL COUNSELOR