Healthcare Provider Details

I. General information

NPI: 1669429254
Provider Name (Legal Business Name): KIRK MITCHELL LUNNEN PHD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 W STATE ST
NEW CASTLE PA
16101-8671
US

IV. Provider business mailing address

2703 W STATE ST
NEW CASTLE PA
16101-8671
US

V. Phone/Fax

Practice location:
  • Phone: 724-657-3303
  • Fax: 724-657-3326
Mailing address:
  • Phone: 724-657-3303
  • Fax: 724-657-3326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPS015405
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS015405
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS015405
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPS015405
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPS015405
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPS045405
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPS015405
License Number StatePA
# 8
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS015405
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: