Healthcare Provider Details

I. General information

NPI: 1942512918
Provider Name (Legal Business Name): ALISA JOYCE DUNKER MAPC, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 WEST BASELINE ROAD SUITE 182A #202
PHOENIX AZ
85041-4815
US

IV. Provider business mailing address

2030 WEST BASELINE ROAD SUITE 182A #202
PHOENIX AZ
85041-4815
US

V. Phone/Fax

Practice location:
  • Phone: 602-299-3545
  • Fax: 602-374-5580
Mailing address:
  • Phone: 602-299-3545
  • Fax: 602-374-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-13281
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: