Active NPI
Jimmy Lee Dunham, LPC
- Professional Counselor
- Livingston, TX
National Provider Identifier
1053889220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 75714
- Practice address
- 1100 Ogletree Dr
Livingston, TX 77351-8454 - Phone
- (936) 327-3786
- NPI assigned
- Nov 6, 2018
- Last updated
- Nov 6, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 75714 | TX | Primary |
Addresses
Primary practice location
1100 Ogletree Dr
Livingston, TX 77351-8454
Mailing address
2001 S Medford Dr
Lufkin, TX 75901-6260
Phone (936) 633-5650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75714 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burke Center | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1053889220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 S MEDFORD DR",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759016260",
"telephone_number": "936-633-5650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 OGLETREE DR",
"city": "LIVINGSTON",
"state": "TX",
"postal_code": "773518454",
"telephone_number": "936-327-3786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "JIMMY",
"middle_name": "LEE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-11-06",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "75714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livingston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.