Provider Demographics
NPI:1669599486
Name:GAREY, DORI K
Entity type:Individual
Prefix:MS
First Name:DORI
Middle Name:K
Last Name:GAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DORI
Other - Middle Name:K
Other - Last Name:GAREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW, LICDC
Mailing Address - Street 1:5213 MEADOW WOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3725
Mailing Address - Country:US
Mailing Address - Phone:440-446-0517
Mailing Address - Fax:
Practice Address - Street 1:21625 CHAGRIN BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5363
Practice Address - Country:US
Practice Address - Phone:440-446-0517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 4234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health