Basic Information
| Provider Information | |||||||||
| NPI: | 1336576495 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUNGEY | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCPC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 W 40TH ST UNIT 2225 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374091379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234860774 | ||||||||
| FaxNumber: | 4234056346 | ||||||||
| Practice Location | |||||||||
| Address1: | 1312 SPRING CREEK RD | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374123918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234860774 | ||||||||
| FaxNumber: | 4234056346 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2013 | ||||||||
| LastUpdateDate: | 10/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 10/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 180-009813 | IL | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 180009813 | IL | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | MH20338 | FL | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | 5008 | TN | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 5008 | 01 | TN | STATE LICENSE | OTHER | 180-009813 | 01 | IL | STATE LICENSE | OTHER | MH20338 | 01 | FL | STATE LICENSE | OTHER |