Provider Demographics
NPI:1053674895
Name:JODY L. DUNN
Entity Type:Organization
Organization Name:JODY L. DUNN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LMFT
Authorized Official - Phone:985-876-2697
Mailing Address - Street 1:1943 HIGHWAY 182
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-3159
Mailing Address - Country:US
Mailing Address - Phone:985-876-2697
Mailing Address - Fax:985-876-2532
Practice Address - Street 1:1943 HIGHWAY 182
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-3159
Practice Address - Country:US
Practice Address - Phone:985-876-2697
Practice Address - Fax:985-876-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2703101YP2500X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty