Healthcare Provider Details

I. General information

NPI: 1669701108
Provider Name (Legal Business Name): FRANDEE DUNMORE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 COMMERCE CIR
FAYETTEVILLE GA
30214-1303
US

IV. Provider business mailing address

PO BOX 143271
FAYETTEVILLE GA
30214-6529
US

V. Phone/Fax

Practice location:
  • Phone: 470-278-5830
  • Fax:
Mailing address:
  • Phone: 470-278-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC004270
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC004270
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004270
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number346854
License Number StateGA
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: