Provider Demographics
NPI:1902640030
Name:DOBRZELEWSKI, LELA (LLMSW)
Entity type:Individual
Prefix:
First Name:LELA
Middle Name:
Last Name:DOBRZELEWSKI
Suffix:
Gender:
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 LIVINGSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-9387
Mailing Address - Country:US
Mailing Address - Phone:989-732-6890
Mailing Address - Fax:989-688-5968
Practice Address - Street 1:90 LIVINGSTON BLVD
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-9387
Practice Address - Country:US
Practice Address - Phone:989-732-6890
Practice Address - Fax:989-688-5968
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6851118288104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker