Provider Demographics
NPI:1548681919
Name:DUNLEVY, RYAN (LPCA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:DUNLEVY
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 NETHERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-4536
Mailing Address - Country:US
Mailing Address - Phone:336-706-6464
Mailing Address - Fax:
Practice Address - Street 1:411 ANDREWS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2993
Practice Address - Country:US
Practice Address - Phone:919-682-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health