Provider Demographics
NPI:1447485735
Name:HEALY, DAWN MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:HEALY
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 1:55 CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-1503
Mailing Address - Country:US
Mailing Address - Phone:706-542-2273
Mailing Address - Fax:706-542-8661
Practice Address - Street 1:55 CARLTON ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-1503
Practice Address - Country:US
Practice Address - Phone:706-542-2273
Practice Address - Fax:706-542-8661
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0038231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2813466OtherCIGNA BEHAVIORAL HEALTH
12010407OtherCAQH
NC6007388Medicaid
GACSW003823OtherGA LICENSE