Provider Demographics
NPI:1730559063
Name:BRENDA DUNN, LCSW
Entity type:Organization
Organization Name:BRENDA DUNN, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:3182-042-8737
Mailing Address - Street 1:129 LIBUSE CUTOFF RD
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-9142
Mailing Address - Country:US
Mailing Address - Phone:318-204-2737
Mailing Address - Fax:318-443-0429
Practice Address - Street 1:129 LIBUSE CUTOFF RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-9142
Practice Address - Country:US
Practice Address - Phone:318-204-2737
Practice Address - Fax:318-443-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA42831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty