Provider Demographics
NPI:1073514725
Name:DUNBAR, DEBBIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 JEFFERSON ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-4050
Mailing Address - Country:US
Mailing Address - Phone:770-732-0190
Mailing Address - Fax:770-732-0333
Practice Address - Street 1:2710 JEFFERSON ST
Practice Address - Street 2:SUITE 6
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-4050
Practice Address - Country:US
Practice Address - Phone:770-732-0190
Practice Address - Fax:770-732-0333
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBDPXMedicare ID - Type Unspecified