Healthcare Provider Details

I. General information

NPI: 1073507042
Provider Name (Legal Business Name): JEFFREY ALLAN DUNN PHD LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 SOUTH MAIN ST SUITE C
WAYNESVILLE NC
28786-2410
US

IV. Provider business mailing address

1170 SOUTH MAIN ST SUITE C
WAYNESVILLE NC
28786-2410
US

V. Phone/Fax

Practice location:
  • Phone: 828-456-1999
  • Fax: 828-456-2333
Mailing address:
  • Phone: 828-456-1999
  • Fax: 828-456-2333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW6111
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC004778
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: