Provider Demographics
NPI:1992759062
Name:O'MEALLY, DAWN ADER (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ADER
Last Name:O'MEALLY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 BALTIMORE BLVD STE 128
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7068
Mailing Address - Country:US
Mailing Address - Phone:410-751-6176
Mailing Address - Fax:410-857-4176
Practice Address - Street 1:909 BALTIMORE BLVD STE 128
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7068
Practice Address - Country:US
Practice Address - Phone:410-751-6176
Practice Address - Fax:410-857-4176
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-21
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD958511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD137P341GMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER