Provider Demographics
NPI:1417010679
Name:DUNLAP, LAUREN A (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 STATE ROUTE 121 BYP N
Mailing Address - Street 2:SUITE D
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-8864
Mailing Address - Country:US
Mailing Address - Phone:270-761-5804
Mailing Address - Fax:270-761-5807
Practice Address - Street 1:1712 STATE ROUTE 121 BYP N
Practice Address - Street 2:SUITE D
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-8864
Practice Address - Country:US
Practice Address - Phone:270-761-5804
Practice Address - Fax:270-761-5807
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3606OtherLCSW