Provider Demographics
NPI:1942488325
Name:DUNN, JOHN T (LCSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:DUNN
Suffix:
Gender:M
Credentials:LCSW
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 426
Mailing Address - Street 2:
Mailing Address - City:SUGAR LOAF
Mailing Address - State:NY
Mailing Address - Zip Code:10981-0426
Mailing Address - Country:US
Mailing Address - Phone:914-273-1260
Mailing Address - Fax:
Practice Address - Street 1:1407 KINGS HWY
Practice Address - Street 2:
Practice Address - City:SUGAR LOAF
Practice Address - State:NY
Practice Address - Zip Code:10981-9800
Practice Address - Country:US
Practice Address - Phone:914-273-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR045-6611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR045-661OtherNYS LISCENSE
NYN6Z211Medicare PIN