Provider Demographics
NPI:1841656741
Name:DUNLAP, RAVEN E (LPC, NCC)
Entity type:Individual
Prefix:DR
First Name:RAVEN
Middle Name:E
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2954 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-4020
Mailing Address - Country:US
Mailing Address - Phone:225-776-9511
Mailing Address - Fax:
Practice Address - Street 1:329 ALLENDALE DR
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-3242
Practice Address - Country:US
Practice Address - Phone:225-308-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional