Provider Demographics
NPI:1730420084
Name:DUNNING, CARRIE ANDERSON (LPC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANDERSON
Last Name:DUNNING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ELIZABETH
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:9200 WATSON RD
Mailing Address - Street 2:SUITE G101
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1528
Mailing Address - Country:US
Mailing Address - Phone:314-544-3800
Mailing Address - Fax:314-843-0552
Practice Address - Street 1:311 S MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-2807
Practice Address - Country:US
Practice Address - Phone:636-281-1990
Practice Address - Fax:636-281-1995
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000175454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional