Provider Demographics
NPI:1801323670
Name:GRABLE-BLEICHRODT, DAWN LEE (LISW-S, LICDC-CS)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:LEE
Last Name:GRABLE-BLEICHRODT
Suffix:
Gender:F
Credentials:LISW-S, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 TALLMADGE RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3362
Mailing Address - Country:US
Mailing Address - Phone:330-436-0957
Mailing Address - Fax:330-436-0959
Practice Address - Street 1:405 TALLMADGE RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3362
Practice Address - Country:US
Practice Address - Phone:330-436-0957
Practice Address - Fax:330-436-0959
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH061044101YA0400X
OHI 09000091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNPI 182118432OtherCLEVELAND CLINIC AKRON GENERAL EDWIN SHAW REHABILITATION HOSPITAL