Provider Demographics
NPI:1598169492
Name:HORAN-DUNN, LISA E (LCSW,LMSW,CASAC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:E
Last Name:HORAN-DUNN
Suffix:
Gender:F
Credentials:LCSW,LMSW,CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:SPRING GLEN
Mailing Address - State:NY
Mailing Address - Zip Code:12483-0091
Mailing Address - Country:US
Mailing Address - Phone:914-850-1726
Mailing Address - Fax:845-647-1205
Practice Address - Street 1:240 LEWIS ROAD
Practice Address - Street 2:
Practice Address - City:SPRING GLEN
Practice Address - State:NY
Practice Address - Zip Code:12483-0091
Practice Address - Country:US
Practice Address - Phone:914-850-1726
Practice Address - Fax:845-647-1205
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11914101YA0400X
NY065903104100000X
NY0735391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker