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General NPI Number Information
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NPI Number | 1346175700
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Entity Type | Individual
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Provider Name | BRANDON H FUNK LPC
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Gender | Male
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 224 CRAIGDAN DR
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City | DALLASTOWN
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State | PA
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Zip | 17313-9422
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Country | US
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Telephone | 307-314-9303
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 E GRAND AVE STE 401
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City | LARAMIE
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State | WY
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Zip | 82070-4388
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Country | US
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Telephone | 307-314-9303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-2576
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License Number State | WY
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