Provider Demographics
NPI:1962714741
Name:DUNN, DAVID (LPC, CAC II)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:LPC, CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:POMARIA
Mailing Address - State:SC
Mailing Address - Zip Code:29126-0181
Mailing Address - Country:US
Mailing Address - Phone:803-446-6506
Mailing Address - Fax:
Practice Address - Street 1:1523 SUNSET BLVD STE B
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-5945
Practice Address - Country:US
Practice Address - Phone:803-446-6506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5380101YP2500X
SC1304237101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)