Healthcare Provider Details

I. General information

NPI: 1841411600
Provider Name (Legal Business Name): CHERYL HEULETTE DUNSTON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERYL HEULETTE DUNSTON-MCLEE PHD

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 YORK RD SUITE 2
BALTIMORE MD
21212
US

IV. Provider business mailing address

5424 GARDENWOOD RD
BALTIMORE MD
21206
US

V. Phone/Fax

Practice location:
  • Phone: 410-537-0698
  • Fax: 410-488-5424
Mailing address:
  • Phone: 410-537-0698
  • Fax: 410-488-5424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCA256
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateMD
# 5
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: