Provider Demographics
NPI:1306200704
Name:DWYER, DONAL JAMES V (LPC)
Entity Type:Individual
Prefix:MR
First Name:DONAL
Middle Name:JAMES
Last Name:DWYER
Suffix:V
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2319
Mailing Address - Country:US
Mailing Address - Phone:989-546-2038
Mailing Address - Fax:231-527-9511
Practice Address - Street 1:117 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2319
Practice Address - Country:US
Practice Address - Phone:989-546-2038
Practice Address - Fax:231-527-9511
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014958101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional