Provider Demographics
NPI:1275277287
Name:DUNLAP, ALESIA CAROL (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ALESIA
Middle Name:CAROL
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 LOWER BLUE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:GA
Mailing Address - Zip Code:31811-6559
Mailing Address - Country:US
Mailing Address - Phone:706-464-0499
Mailing Address - Fax:
Practice Address - Street 1:1605 LOWER BLUE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:GA
Practice Address - Zip Code:31811-6559
Practice Address - Country:US
Practice Address - Phone:706-464-0499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012128101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty