Provider Demographics
NPI:1972041739
Name:DUNLAP, BRENDA (LPC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W153N11856 DANIELS DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-2066
Mailing Address - Country:US
Mailing Address - Phone:262-366-4500
Mailing Address - Fax:262-335-6827
Practice Address - Street 1:W227N6103 SUSSEX RD
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3969
Practice Address - Country:US
Practice Address - Phone:414-566-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6242-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health