Provider Demographics
NPI:1831506294
Name:DUNAWAY, MICHAEL (MED, LPC-A, NCC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DUNAWAY
Suffix:
Gender:M
Credentials:MED, LPC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 GRAND PINE PL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-4175
Mailing Address - Country:US
Mailing Address - Phone:919-623-0404
Mailing Address - Fax:
Practice Address - Street 1:602 E ACADEMY ST
Practice Address - Street 2:SUITE 105
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2382
Practice Address - Country:US
Practice Address - Phone:919-753-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10007101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional