Provider Demographics
NPI:1457343535
Name:DUNN, ROBIN WESLEY (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:WESLEY
Last Name:DUNN
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 COVE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-1363
Mailing Address - Country:US
Mailing Address - Phone:770-548-1966
Mailing Address - Fax:706-692-2221
Practice Address - Street 1:505 COVE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-1363
Practice Address - Country:US
Practice Address - Phone:770-548-1966
Practice Address - Fax:706-692-2221
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA261654221OtherTAX ID
GA700781091AMedicaid
GA700781091AMedicaid