Provider Demographics
NPI:1992381396
Name:DUNN, LISA (MSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 UNION ST APT 2O
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2793
Mailing Address - Country:US
Mailing Address - Phone:201-788-0549
Mailing Address - Fax:
Practice Address - Street 1:109 KIEL AVE
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2543
Practice Address - Country:US
Practice Address - Phone:973-838-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05865800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker