Provider Demographics
NPI:1730597568
Name:DUNKLEY, BUDDY JR (LPC)
Entity type:Individual
Prefix:MR
First Name:BUDDY
Middle Name:
Last Name:DUNKLEY
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:STANAFORD
Mailing Address - State:WV
Mailing Address - Zip Code:25927-0214
Mailing Address - Country:US
Mailing Address - Phone:304-237-0774
Mailing Address - Fax:
Practice Address - Street 1:180 OAHU ST.
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:304-237-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11025101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health