Organization
DUNLEAVY FAMILY THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER L DUNLEAVY MA, MED, LMFT, ASDCS (THERAPIST/CEO)
(336) 497-5271
Entity
Organization
Contact information
Practice address
950 GRAVES ST STE G, KERNERSVILLE, NC 27284-3246
(336) 497-5271
(336) 360-6724
Mailing address
950 GRAVES ST STE G, KERNERSVILLE, NC 27284-3246
(336) 497-5271
(336) 360-6724
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386197002
NPI
NC
01
—
1930
NC MFT LICENSURE BOARD
NC
Enumeration date
06/30/2021
Last updated
10/06/2021
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