Provider Demographics
NPI:1821538430
Name:DUNN, RICHARD MACON (CADC-II)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MACON
Last Name:DUNN
Suffix:
Gender:M
Credentials:CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-3026
Mailing Address - Country:US
Mailing Address - Phone:336-309-1566
Mailing Address - Fax:
Practice Address - Street 1:208 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-3026
Practice Address - Country:US
Practice Address - Phone:336-309-1566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA933101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)