Provider Demographics
NPI:1578236899
Name:DUNLAP-GRIFFIN, BREONA (LCPC, CSC-AD)
Entity Type:Individual
Prefix:
First Name:BREONA
Middle Name:
Last Name:DUNLAP-GRIFFIN
Suffix:
Gender:F
Credentials:LCPC, CSC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 ROCKVILLE PIKE STE 250-207
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1486
Mailing Address - Country:US
Mailing Address - Phone:443-687-9784
Mailing Address - Fax:
Practice Address - Street 1:1451 ROCKVILLE PIKE STE 250-207
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1486
Practice Address - Country:US
Practice Address - Phone:443-687-9784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MDLC12972101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)