Organization Active NPI

Dunn Psychological Associates, PA

  • Clinical Psychologist
  • Dunn, NC
National Provider Identifier
1174712798
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2015 Issued in NC
Legal business name
DUNN PSYCHOLOGICAL ASSOCIATES, PA
Practice address
102 Tilghman Dr
Dunn, NC 28334-5533
Phone
(910) 892-5839
Fax
(910) 892-5771
NPI assigned
Oct 19, 2007
Last updated
Oct 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Michael Dermott, PSY.D.NPI 1295872729
Title
Director
Phone
(910) 892-5839

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3185 NC
Clinical Psychologist 103TC0700X 2015 NC Primary

Addresses

Primary practice location

102 Tilghman Dr
Dunn, NC 28334-5533

Mailing address

PO Box 487
Dunn, NC 28335-0487
Phone (910) 892-5839

Other identifiers 1

IdentifierTypeStateIssuer
6006194MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1174712798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283350487",
            "telephone_number": "910-892-5839",
            "fax_number": "910-892-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 TILGHMAN DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345533",
            "telephone_number": "910-892-5839",
            "fax_number": "910-892-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNN PSYCHOLOGICAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "DERMOTT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-892-5839",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3185",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006194",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.