Provider Demographics
NPI:1922045566
Name:DUNKEL, JEAN (LCSW C)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:DUNKEL
Suffix:
Gender:F
Credentials:LCSW C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SISTER PIERRE DRIVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-823-6408
Mailing Address - Fax:443-279-0537
Practice Address - Street 1:120 SISTER PIERRE DRIVE
Practice Address - Street 2:SUITE 403
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-823-6408
Practice Address - Fax:443-279-0537
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD029721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
069051000OtherMAGE
253539OtherCOMP
360218OtherMHN
593795443OtherMAMS
150NOtherMEMD
2512798OtherUNHC
252450OtherCOMP
117959OtherMHN
226108OtherKAIS
26601OtherCIGN
0005OtherBSDC
2392061OtherUNHC
361780OtherMAMS
705BPSOtherBSMD
790298000OtherMAGE
41301102OtherBSMD
PVPB118079OtherAPS
002601OtherVAL
150N135GOtherMBMD
K452OtherBSDC