Provider Demographics
NPI:1679375125
Name:DEMBOWSKI, JOHN WALTER (COUNSELOR)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WALTER
Last Name:DEMBOWSKI
Suffix:
Gender:
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 W MARKET ST STE 105
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2494
Mailing Address - Country:US
Mailing Address - Phone:216-704-6093
Mailing Address - Fax:
Practice Address - Street 1:2092 16TH STREET
Practice Address - Street 2:SW.
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314
Practice Address - Country:US
Practice Address - Phone:216-704-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPP000922715175T00000X
OHAPP-000922715101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No175T00000XOther Service ProvidersPeer Specialist