Provider Demographics
NPI:1659833317
Name:DUNN, AUTUMN C (LPC-IT)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:C
Last Name:DUNN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:C
Other - Last Name:LEMKE-ROCHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 N SUNNY SLOPE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4806
Mailing Address - Country:US
Mailing Address - Phone:262-432-5660
Mailing Address - Fax:262-432-5666
Practice Address - Street 1:150 N SUNNY SLOPE RD STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4806
Practice Address - Country:US
Practice Address - Phone:262-432-5660
Practice Address - Fax:262-432-5666
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3780-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional