Provider Demographics
NPI:1841367331
Name:DUNGAN, WILLIAM JOSEPH (LCSW LICENSED CLINIC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:DUNGAN
Suffix:
Gender:M
Credentials:LCSW LICENSED CLINIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 OHIO STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501
Mailing Address - Country:US
Mailing Address - Phone:606-451-8514
Mailing Address - Fax:606-451-8514
Practice Address - Street 1:218 OHIO STREET
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501
Practice Address - Country:US
Practice Address - Phone:606-451-8514
Practice Address - Fax:606-451-8514
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RVRB127927OtherAPS
KY8200077900Medicaid
106717OtherAETNA VALUE OPTIONS
000000108317OtherANTHEM BCBS
99404CPT273171OtherEAP US POSTAL
2176722OtherCIGNA
6280471OtherUNITED BEHAVIORAL HEALTH
HUKY0555OtherHUMANA CORPHEALTH
1192115OtherCHA
M680OtherANTHEM BCBS
RVRB127927OtherAPS
HUKY0555OtherHUMANA CORPHEALTH