MEDICARE: MISS DAWN MARNIECE BURNS LSW, MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	150.110485	IL

General Provider Information

NPI Number	:	1336654169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DAWN MARNIECE BURNS LSW, MSW

Provider Business Mailing Address
First Line	:	2490 NOBLE RD STE 101
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2161
Country	:	US
Telephone Number	:	216-795-5066
Fax Number	:	216-795-5495

Provider Business Practice Location Address
First Line	:	2490 NOBLE RD STE 101
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121
Country	:	US
Telephone Number	:	216-795-5066
Fax Number	:	216-795-5495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2017
Last Update Date	:	04/23/2026

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