Healthcare Provider Details

I. General information

NPI: 1205588548
Provider Name (Legal Business Name): RILEY K. DUNN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE DUNN LCSW

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 PERKINS LN
JACKSBORO TN
37757-2833
US

IV. Provider business mailing address

2842 FISH HATCHERY RD
MORRISTOWN TN
37813-1731
US

V. Phone/Fax

Practice location:
  • Phone: 865-205-0987
  • Fax:
Mailing address:
  • Phone: 352-226-3710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10226
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: