Provider Demographics
NPI:1669139408
Name:DUNLAP, STEPHEN MARK (LPC-S)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MARK
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 GAINSBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121-1307
Mailing Address - Country:US
Mailing Address - Phone:806-206-9456
Mailing Address - Fax:
Practice Address - Street 1:7411 GAINSBOROUGH DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1307
Practice Address - Country:US
Practice Address - Phone:806-206-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-28
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health