Healthcare Provider Details

I. General information

NPI: 1144069352
Provider Name (Legal Business Name): RIAN B DUNKIN LPC, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NE MISSOURI RD STE 307
LEES SUMMIT MO
64086-4722
US

IV. Provider business mailing address

4429 S RIVER BLVD STE BC
INDEPENDENCE MO
64055-4659
US

V. Phone/Fax

Practice location:
  • Phone: 816-839-9427
  • Fax:
Mailing address:
  • Phone: 816-768-0090
  • Fax: 816-912-1739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2016008299
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2022049227
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: