Healthcare Provider Details

I. General information

NPI: 1962232884
Provider Name (Legal Business Name): ANTHONY BRUNSWICK LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TONY BRUNSWICK LPC

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 P ST NW STE 600
WASHINGTON DC
20036-6920
US

IV. Provider business mailing address

2000 P ST NW STE 600
WASHINGTON DC
20036-6920
US

V. Phone/Fax

Practice location:
  • Phone: 202-556-1984
  • Fax:
Mailing address:
  • Phone: 202-556-1984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGPC200001681
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGPC200001681
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGPC200001681
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: