Provider Demographics
NPI:1649593526
Name:LUNG, DANA (LMFT, LMHC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:LUNG
Suffix:
Gender:F
Credentials:LMFT, LMHC
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 10907
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-0907
Mailing Address - Country:US
Mailing Address - Phone:727-481-4577
Mailing Address - Fax:727-498-5698
Practice Address - Street 1:1631 9TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4203
Practice Address - Country:US
Practice Address - Phone:727-481-4577
Practice Address - Fax:727-498-5698
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8282101YM0800X
CAMFC40055101YM0800X
FLMT2261101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health