Provider Demographics
NPI:1205837796
Name:DUNN, TIMOTHY (LPC LMFT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHESTNUT ST
Mailing Address - Street 2:SUITE 1445
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1453
Mailing Address - Country:US
Mailing Address - Phone:325-437-1445
Mailing Address - Fax:325-437-1434
Practice Address - Street 1:500 CHESTNUT ST
Practice Address - Street 2:SUITE 1445
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1453
Practice Address - Country:US
Practice Address - Phone:325-437-1445
Practice Address - Fax:325-437-1434
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18008101YM0800X
TX05119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156300901Medicaid