MEDICARE: DONNA DUNN 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
1	1041C0700X	Clinical Social Worker	CSW003568	GA

General Provider Information

NPI Number	:	1851612238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA DUNN LCSW

Provider Business Mailing Address
First Line	:	238 TOLHURST RD
Second Line	:
City	:	CLEVELAND
State	:	GA
Zip	:	30528-2316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 NORTH AVE STE 100
Second Line	:
City	:	CLEVELAND
State	:	GA
Zip	:	30528-1398
Country	:	US
Telephone Number	:	706-878-9619
Fax Number	:

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

Provider Enumeration Date	:	06/19/2010
Last Update Date	:	04/04/2011

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Directions to “ DONNA DUNN LCSW” Practice Location

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