# DUNLEAVY FAMILY THERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811567977
- **Authorized official:** HEATHER L DUNLEAVY MA, MED, LMFT, ASDCS (THERAPIST/CEO)
- **Authorized official phone:** (336) 497-5271

## Contact information

- **Practice address:** 950 GRAVES ST STE G, KERNERSVILLE, NC 27284-3246
- **Practice address phone:** (336) 497-5271
- **Practice address fax:** (336) 360-6724
- **Mailing address:** 950 GRAVES ST STE G, KERNERSVILLE, NC 27284-3246
- **Mailing address phone:** (336) 497-5271
- **Mailing address fax:** (336) 360-6724

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/30/2021
- **Last updated:** 10/06/2021