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NPI Code Detail

MEDICARE: DR. JEFFREY ALLAN DUNN PHD LCSW

MEDICARE:  DR. JEFFREY ALLAN DUNN  PHD  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW6111FL
21041C0700XClinical Social WorkerC004778NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z9708OTHERFLBLUE CROSS BLUE SHEILD

General Provider Information

NPI Number : 1073507042
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY ALLAN DUNN PHD LCSW
Provider Business Mailing Address
First Line : 1170 SOUTH MAIN ST
Second Line : SUITE C
City : WAYNESVILLE
State : NC
Zip : 28786-2410
Country : US
Telephone Number : 828-456-1999
Fax Number : 828-456-2333
Provider Business Practice Location Address
First Line : 1170 SOUTH MAIN ST
Second Line : SUITE C
City : WAYNESVILLE
State : NC
Zip : 28786-2410
Country : US
Telephone Number : 828-456-1999
Fax Number : 828-456-2333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 10/09/2007

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