Provider Demographics
NPI:1184367062
Name:DUNN, NANCY LEE (LMSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LEE
Last Name:DUNN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 STATE ROUTE 28N
Mailing Address - Street 2:
Mailing Address - City:NORTH CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:12853-3903
Mailing Address - Country:US
Mailing Address - Phone:518-260-9901
Mailing Address - Fax:
Practice Address - Street 1:326 STATE ROUTE 28N
Practice Address - Street 2:
Practice Address - City:NORTH CREEK
Practice Address - State:NY
Practice Address - Zip Code:12853-3903
Practice Address - Country:US
Practice Address - Phone:518-260-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114280101YM0800X
NY114280-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health