Healthcare Provider Details

I. General information

NPI: 1447565031
Provider Name (Legal Business Name): DAWN THEREASA BIRCHENOUGH MA, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN T CORTEZ MCKEE MA, LSW

II. Dates (important events)

Enumeration Date: 08/08/2010
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 E TURKEYFOOT LAKE RD STE 100
AKRON OH
44312-5277
US

IV. Provider business mailing address

221 W LIBERTY ST
MEDINA OH
44256-2217
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-5015
  • Fax:
Mailing address:
  • Phone: 330-722-4166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1800904
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: