Provider Demographics
NPI:1609557446
Name:DUNLAP- DYE, LISA MARIE (LPC-A, NCC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:DUNLAP- DYE
Suffix:
Gender:F
Credentials:LPC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 BOWSER ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5046
Mailing Address - Country:US
Mailing Address - Phone:803-389-6256
Mailing Address - Fax:
Practice Address - Street 1:222 BOWSER ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5046
Practice Address - Country:US
Practice Address - Phone:803-389-6256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7610101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health