=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164642567
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DUNBAR BEHAVIORAL & COUSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9308 TWO NOTCH RD
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29223-6401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-609-3889
-----------------------------------------------------
Fax | 803-936-0168
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2193
-----------------------------------------------------
City | WEST COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29171-2193
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-609-3889
-----------------------------------------------------
Fax | 803-936-0168
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JAMES DAVID DUNBAR
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 803-609-3889
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 408
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------