Provider Demographics
NPI:1073507042
Name:DUNN, JEFFREY ALLAN (PHD LCSW)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLAN
Last Name:DUNN
Suffix:
Gender:M
Credentials:PHD LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 SOUTH MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-2410
Mailing Address - Country:US
Mailing Address - Phone:828-456-1999
Mailing Address - Fax:828-456-2333
Practice Address - Street 1:1170 SOUTH MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-2410
Practice Address - Country:US
Practice Address - Phone:828-456-1999
Practice Address - Fax:828-456-2333
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW61111041C0700X
NCC0047781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9708OtherBLUE CROSS BLUE SHEILD
NC2869689Medicare PIN
FLZ9708OtherBLUE CROSS BLUE SHEILD