Provider Demographics
NPI:1134478092
Name:DUNBAR, EDWARD TIMOTHY JR (LCPC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:TIMOTHY
Last Name:DUNBAR
Suffix:JR
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:NC
Mailing Address - Zip Code:27936-0669
Mailing Address - Country:US
Mailing Address - Phone:252-495-2420
Mailing Address - Fax:844-496-9277
Practice Address - Street 1:53269 RUNBOAT CIRCLE
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:NC
Practice Address - Zip Code:27936
Practice Address - Country:US
Practice Address - Phone:252-495-2420
Practice Address - Fax:844-496-9277
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2403101YA0400X
NCA10394101YP2500X
101YP2500X
MTBBH-LCPC-LIC-26538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty