Provider Demographics
NPI:1760757843
Name:DUNAWAY, BRITAIN (MAC, LCPC)
Entity Type:Individual
Prefix:MR
First Name:BRITAIN
Middle Name:
Last Name:DUNAWAY
Suffix:
Gender:M
Credentials:MAC, LCPC
Other - Prefix:MR
Other - First Name:BRIT
Other - Middle Name:
Other - Last Name:DUNAWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAC, LCPC
Mailing Address - Street 1:808 S ELDORADO RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-6075
Mailing Address - Country:US
Mailing Address - Phone:309-706-3190
Mailing Address - Fax:309-588-4115
Practice Address - Street 1:808 S ELDORADO RD STE 102
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-6075
Practice Address - Country:US
Practice Address - Phone:309-706-3190
Practice Address - Fax:309-588-4115
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007918101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health