Kenneth Lee Dunham III, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

17944 Issued in CA

Practice address

1899 E Roseville Pkwy Ste 100
Roseville, CA 95661-7980

Phone

(209) 783-8586

NPI assigned

Feb 14, 2022

Last updated

Dec 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bayside Counseling Center Inc

  • Mental Health Counselor
  • Roseville, CA
  • NPI 1336093301
  NPD (past)
• Youth for Christ Central Valley

  • Marriage & Family Therapist
  • Modesto, CA
  • NPI 1891303731
  NPD (past)

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1235884644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 BEACHCOMBER DR E",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956774783",
            "telephone_number": "209-201-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 E ROSEVILLE PKWY STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617980",
            "telephone_number": "209-783-8586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8303 Sierra College Blvd Ste 146",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956619419",
            "country_code": "US",
            "telephone_number": "916-746-7235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNHAM",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_suffix": "III",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "17944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Campbell Dukovich, M.S.
• Kevin Dumitru, MPT
• Carrissa Jean Angelique Duncan, LMFT
• Noble A Duncan
• Kathryn Judson Dungan, MS
• Steven D. Dunlap, MD
• Dana Charles Dunlavey, M.D
• Ashlee Marie Dunn, RADT-I
• Emily Dunn
• Jenny Dunn, BCABA

• Professional Counselor in Roseville, CA
• Providers in Roseville, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.