Healthcare Provider Details

I. General information

NPI: 1538117296
Provider Name (Legal Business Name): CLIFFORD ROBERT DUNNING PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVENUE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

1712 ARBOR VIEW RD
SILVER SPRING MD
20902-1411
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-0500
  • Fax:
Mailing address:
  • Phone: 301-933-2755
  • Fax: 703-241-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCM091
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC0443
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0717000761
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701000470
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC111
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: