Provider Demographics
NPI:1164777140
Name:DUNLAP, LINDA (LICDC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 STATE RTE. 28
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140
Mailing Address - Country:US
Mailing Address - Phone:513-575-0968
Mailing Address - Fax:513-575-1019
Practice Address - Street 1:1569 STATE ROUTE 28
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-6086
Practice Address - Country:US
Practice Address - Phone:513-575-0968
Practice Address - Fax:513-575-1019
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH912993101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)