Provider Demographics
NPI:1669429254
Name:LUNNEN, KIRK MITCHELL (PHD)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:MITCHELL
Last Name:LUNNEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-8671
Mailing Address - Country:US
Mailing Address - Phone:724-657-3303
Mailing Address - Fax:724-657-3326
Practice Address - Street 1:2703 W STATE ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-8671
Practice Address - Country:US
Practice Address - Phone:724-657-3303
Practice Address - Fax:724-657-3326
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015405103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X, 103TF0200X, 103TM1800X, 103T00000X
PAPS045405103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA196568000OtherCBHNP
PA2367357OtherCIGNA BEHAVIORAL HEALTH
PA251830792OtherMH NET
251830792OtherCORP HEALTH/HUMANA
PA1669429254OtherRAILROAD MEDICARE/PALMETTO GBA
PA2642423OtherUNITED HEALTHCARE
251830792OtherBWC-OHIO BETTER WORKER'S
PA491628OtherVALUE OPTIONS
PA001502976OtherKEYSTONE HEALTH PLAN WEST
PA001965800002Medicaid
PA251830792OtherINTERGROUP SERVICES CORPORATION
PA000000207502OtherUNISON HEALTH PLAN
12732688OtherMULTIPLAN
PA796967000OtherMAGELLAN BEHAVIORALHEALTH
PA9064112OtherAETNA BEHAVIORAL HEALTH
PALU1502976OtherPREMIERBLUE SHIELD NUMBER
PA2642423OtherUNITED HEALTHCARE