Basic Information
Provider Information
NPI: 1831826981
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUNCH
FirstName: BRITTNEY
MiddleName: ELAINE
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13816 BRADDOCK SPRINGS RD APT L
Address2:  
City: CENTREVILLE
State: VA
PostalCode: 201214209
CountryCode: US
TelephoneNumber: 7037746699
FaxNumber:  
Practice Location
Address1: 7969 ASHTON AVE
Address2:  
City: MANASSAS
State: VA
PostalCode: 201092885
CountryCode: US
TelephoneNumber: 7037927800
FaxNumber: 7037925699
Other Information
ProviderEnumerationDate: 08/08/2022
LastUpdateDate: 08/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X  Y Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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