Provider Demographics
NPI:1831764539
Name:DUNN, HEATHER (LSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PORT DR
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-4370
Mailing Address - Country:US
Mailing Address - Phone:973-534-0690
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST REAR
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1937
Practice Address - Country:US
Practice Address - Phone:973-534-0690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00370800101YA0400X
PACW0242721041C0700X
NJ44SC061438001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)