Active NPI
Paul Michael Dunaway, LPC-MHSP, CRC, NCC
- Mental Health Counselor
- Memphis, TN
National Provider Identifier
1487174306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 5959 Park Ave
Memphis, TN 38119-5200 - Phone
- (017) 651-4009
- Fax
- (901) 765-1085
- NPI assigned
- Jun 21, 2017
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
5959 Park Ave
Memphis, TN 38119-5200
Mailing address
5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-1400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4000 | TN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1487174306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 PARK AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381195200",
"telephone_number": "901-765-1400",
"fax_number": "901-765-1085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5959 PARK AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381195200",
"telephone_number": "017-651-4009",
"fax_number": "901-765-1085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNAWAY",
"first_name": "PAUL",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "LPC-MHSP, CRC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-21",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.