Provider Demographics
NPI:1023425949
Name:DUNNING, KATIE I (LMSW)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:DUNNING
Suffix:I
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:DUNNING-BURLESON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:6128 RICH ST
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-8930
Mailing Address - Country:US
Mailing Address - Phone:810-625-3434
Mailing Address - Fax:
Practice Address - Street 1:1420 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-6208
Practice Address - Country:US
Practice Address - Phone:810-238-0475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225500000X
MI68010995891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist