Provider Demographics
NPI:1962029546
Name:DUNN, DEANNA DALE (LPC)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:DALE
Last Name:DUNN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N SCHOOL AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-5162
Mailing Address - Country:US
Mailing Address - Phone:479-856-2883
Mailing Address - Fax:
Practice Address - Street 1:230 W CENTER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5934
Practice Address - Country:US
Practice Address - Phone:479-856-2883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2203011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP2203011OtherARKANSAS BOARD OF EXAMINERS IN COUNSELING