Provider Demographics
NPI:1245219005
Name:DUNBAR, PATRICIA ANDERSON (MSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANDERSON
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:IA
Mailing Address - Zip Code:51566-1777
Mailing Address - Country:US
Mailing Address - Phone:712-623-5673
Mailing Address - Fax:712-623-8188
Practice Address - Street 1:1000 N BROADWAY ST
Practice Address - Street 2:SUITE C
Practice Address - City:RED OAK
Practice Address - State:IA
Practice Address - Zip Code:51566-1454
Practice Address - Country:US
Practice Address - Phone:712-623-8180
Practice Address - Fax:712-623-8188
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA024621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2205179Medicaid
IA25220OtherWELLMARK
IA11404436OtherCAQH
IA2091633OtherCIGNA BEHAVIORAL HEALTH
IA25220OtherWELLMARK