Provider Demographics
NPI:1669013223
Name:DUNAGAN, RANDY (LMFT)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:DUNAGAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 UNION SQ W STE 535
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3232
Mailing Address - Country:US
Mailing Address - Phone:212-645-0003
Mailing Address - Fax:
Practice Address - Street 1:41 UNION SQ W STE 535
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3232
Practice Address - Country:US
Practice Address - Phone:212-645-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001400-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist