Provider Demographics
NPI:1487090908
Name:DUNN, CASSANDRA (MSW)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 LACEY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1051
Mailing Address - Country:US
Mailing Address - Phone:732-403-6528
Mailing Address - Fax:
Practice Address - Street 1:1044 LACEY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1051
Practice Address - Country:US
Practice Address - Phone:732-403-6528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC047482001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical