Provider Demographics
NPI:1447273669
Name:DUNN, SUSAN (MS, LCSW, LMHC, LMFT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:MS, LCSW, LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1020
Mailing Address - Country:US
Mailing Address - Phone:574-360-4066
Mailing Address - Fax:866-843-2486
Practice Address - Street 1:501 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1020
Practice Address - Country:US
Practice Address - Phone:574-360-4066
Practice Address - Fax:866-843-2486
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000384A101YM0800X
IN34003089A1041C0700X
IN35000608A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist