Provider Demographics
NPI:1457733776
Name:REALE, DAWNN D (LCSW)
Entity Type:Individual
Prefix:
First Name:DAWNN
Middle Name:D
Last Name:REALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DAWNN
Other - Middle Name:
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8635 W SAHARA AVE # 3085
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5858
Mailing Address - Country:US
Mailing Address - Phone:726-203-2002
Mailing Address - Fax:210-245-8423
Practice Address - Street 1:1714 MACCHIA AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-2403
Practice Address - Country:US
Practice Address - Phone:726-203-2002
Practice Address - Fax:210-245-8423
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10003-C1041C0700X
IN34009797A1041C0700X
PACW023043P1041C0700X
TX566581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical