Provider Demographics
NPI:1295996130
Name:DUNN, DAVID BENJAMIN II (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BENJAMIN
Last Name:DUNN
Suffix:II
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 RUCKER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-3631
Mailing Address - Country:US
Mailing Address - Phone:334-360-0856
Mailing Address - Fax:334-475-4233
Practice Address - Street 1:1247 RUCKER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-3631
Practice Address - Country:US
Practice Address - Phone:334-360-0856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1299A101YP2500X
AL2652101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL103580Medicaid