Provider Demographics
NPI:1720541451
Name:DUNN, JASMINE MICHELLE (LICDC-ICADC)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MICHELLE
Last Name:DUNN
Suffix:
Gender:F
Credentials:LICDC-ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 ELSINORE PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1459
Mailing Address - Country:US
Mailing Address - Phone:833-510-4357
Mailing Address - Fax:866-459-6532
Practice Address - Street 1:3768 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2925
Practice Address - Country:US
Practice Address - Phone:833-510-4357
Practice Address - Fax:866-459-6532
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC2002239-TRNEE101Y00000X
OH161988101YA0400X
OH162084101YA0400X
OHLICDC.162084101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor