Provider Demographics
NPI:1205073699
Name:DAWN K. STANISZEWSKI, LCSW-C, LLC
Entity type:Organization
Organization Name:DAWN K. STANISZEWSKI, LCSW-C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:STANISZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:410-573-5353
Mailing Address - Street 1:133 DEFENSE HWY
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7098
Mailing Address - Country:US
Mailing Address - Phone:410-573-5353
Mailing Address - Fax:443-283-4118
Practice Address - Street 1:133 DEFENSE HWY
Practice Address - Street 2:SUITE 114
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7098
Practice Address - Country:US
Practice Address - Phone:410-573-5353
Practice Address - Fax:443-283-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD141540Medicare PIN