Provider Demographics
NPI:1033286745
Name:DUNAGAN, LISA (LCMHC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DUNAGAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 ISLINGTON ST
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4225
Mailing Address - Country:US
Mailing Address - Phone:603-674-8748
Mailing Address - Fax:603-427-6555
Practice Address - Street 1:539 ISLINGTON ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4225
Practice Address - Country:US
Practice Address - Phone:603-674-8748
Practice Address - Fax:603-427-6555
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH05DNL67191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH14Y001424NH02OtherANTHEM