Provider Demographics
NPI:1194850081
Name:STEFANSKI, DAWN MARIE (BS, LBSW, CAC R)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:STEFANSKI
Suffix:
Gender:F
Credentials:BS, LBSW, CAC R
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:GREVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:241 E KOTT RD
Mailing Address - Street 2:
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-9148
Mailing Address - Country:US
Mailing Address - Phone:231-723-1132
Mailing Address - Fax:
Practice Address - Street 1:241 E KOTT RD
Practice Address - Street 2:
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-9148
Practice Address - Country:US
Practice Address - Phone:231-723-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2-00446 (CAC II)101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)