Provider Demographics
NPI:1952545873
Name:YABLONSKY, DAWN ILISA (LCSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ILISA
Last Name:YABLONSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3312
Mailing Address - Country:US
Mailing Address - Phone:516-665-9309
Mailing Address - Fax:
Practice Address - Street 1:117 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3312
Practice Address - Country:US
Practice Address - Phone:516-665-9309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071707-1104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator