MEDICARE: SAMANTHA DUNN LMSW

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	1041C0700X	Clinical Social Worker	MSW009839	GA

General Provider Information

NPI Number	:	1689361214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA DUNN LMSW

Provider Business Mailing Address
First Line	:	724 BLANTON BLVD
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-4329
Country	:	US
Telephone Number	:	478-397-3951
Fax Number	:

Provider Business Practice Location Address
First Line	:	5465 SW 34TH ST
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-5032
Country	:	US
Telephone Number	:	352-384-3560
Fax Number	:

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

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	05/29/2026

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