Provider Demographics
NPI:1689451064
Name:DUNN, LILLIAN (LSW)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3303
Mailing Address - Country:US
Mailing Address - Phone:317-417-0373
Mailing Address - Fax:
Practice Address - Street 1:1518 WALNUT ST STE 401
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3403
Practice Address - Country:US
Practice Address - Phone:267-996-9964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140099104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker