Provider Demographics
NPI:1710420872
Name:DUNN, CARRIE (LMSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:LMSW
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 14400
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29587-4400
Mailing Address - Country:US
Mailing Address - Phone:843-839-5433
Mailing Address - Fax:843-839-4555
Practice Address - Street 1:1500 HWY 17 BUS, NORTH
Practice Address - Street 2:SUITE 210
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29587-4400
Practice Address - Country:US
Practice Address - Phone:843-839-5433
Practice Address - Fax:843-839-4555
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11141104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker