Provider Demographics
NPI:1013206473
Name:DULANEY, JOHN SELKIRK JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:SELKIRK
Last Name:DULANEY
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:270 GREENWICH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6530
Mailing Address - Country:US
Mailing Address - Phone:203-869-1970
Mailing Address - Fax:860-350-2832
Practice Address - Street 1:270 GREENWICH AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6530
Practice Address - Country:US
Practice Address - Phone:203-869-1970
Practice Address - Fax:860-350-2832
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health