1326469909 NPI number — MRS. ALLYSE RENAE DUNLOP MA, LPC

Table of content: MRS. ALLYSE RENAE DUNLOP MA, LPC (NPI 1326469909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326469909 NPI number — MRS. ALLYSE RENAE DUNLOP MA, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNLOP
Provider First Name:
ALLYSE
Provider Middle Name:
RENAE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOORE
Provider Other First Name:
ALLYSE
Provider Other Middle Name:
RENAE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326469909
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2910 E WASHINGTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VINTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24179-1314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-562-3900
Provider Business Mailing Address Fax Number:
540-890-5814

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2910 E WASHINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VINTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24179-1314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-562-3900
Provider Business Practice Location Address Fax Number:
540-890-5814
Provider Enumeration Date:
12/26/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  0701007251 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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