Provider Demographics
NPI:1497289276
Name:DUNN, KIONA SHEREE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KIONA
Middle Name:SHEREE
Last Name:DUNN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6691 CHURCH ST UNIT 962378
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-4095
Mailing Address - Country:US
Mailing Address - Phone:202-403-4322
Mailing Address - Fax:
Practice Address - Street 1:333 S 9TH ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4111
Practice Address - Country:US
Practice Address - Phone:678-334-3441
Practice Address - Fax:678-669-2620
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC01269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003184502AMedicaid