Provider Demographics
NPI:1700650108
Name:DUNN, KASSY (LAC)
Entity Type:Individual
Prefix:
First Name:KASSY
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 E 41ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6048
Mailing Address - Country:US
Mailing Address - Phone:605-444-7643
Mailing Address - Fax:605-444-7690
Practice Address - Street 1:705 E 41ST ST STE 200
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6048
Practice Address - Country:US
Practice Address - Phone:605-444-7643
Practice Address - Fax:605-444-7690
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD18031777101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)