MEDICARE: MR. TIMOTHY DUNN LPC LMFT

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
1	101YM0800X	Mental Health Counselor	18008	TX
2	106H00000X	Marriage & Family Therapist	05119	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205837796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY DUNN LPC LMFT

Provider Business Mailing Address
First Line	:	500 CHESTNUT ST
Second Line	:	SUITE 1445
City	:	ABILENE
State	:	TX
Zip	:	79602-1453
Country	:	US
Telephone Number	:	325-437-1445
Fax Number	:	325-437-1434

Provider Business Practice Location Address
First Line	:	500 CHESTNUT ST
Second Line	:	SUITE 1445
City	:	ABILENE
State	:	TX
Zip	:	79602-1453
Country	:	US
Telephone Number	:	325-437-1445
Fax Number	:	325-437-1434

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	08/15/2013

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