Provider Demographics
NPI:1386002244
Name:DUNN, LAVONDA (MS, LCPC)
Entity Type:Individual
Prefix:
First Name:LAVONDA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 YORKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-3541
Mailing Address - Country:US
Mailing Address - Phone:301-730-4192
Mailing Address - Fax:
Practice Address - Street 1:5 PUBLIC SQ STE 207
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5599
Practice Address - Country:US
Practice Address - Phone:301-730-4192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional