Provider Demographics
NPI:1386203479
Name:DUNN, KEYA SHANAE (LCMHC)
Entity type:Individual
Prefix:
First Name:KEYA
Middle Name:SHANAE
Last Name:DUNN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10431 BIRCH HILL DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0467
Mailing Address - Country:US
Mailing Address - Phone:336-391-3963
Mailing Address - Fax:
Practice Address - Street 1:10431 BIRCH HILL DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-0467
Practice Address - Country:US
Practice Address - Phone:336-391-3963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health