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NPI Code Detail

MEDICARE: MR. BRITAIN DUNAWAY MAC, LCPC

MEDICARE:  MR. BRITAIN  DUNAWAY  MAC, LCPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor180.007918IL
2101YM0800XMental Health Counselor180.007918IL

General Provider Information

NPI Number : 1760757843
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRITAIN DUNAWAY MAC, LCPC
Provider Business Mailing Address
First Line : 808 S ELDORADO RD STE 102
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61704-6075
Country : US
Telephone Number : 309-706-3190
Fax Number : 309-588-4115
Provider Business Practice Location Address
First Line : 808 S ELDORADO RD STE 102
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61704-6075
Country : US
Telephone Number : 309-706-3190
Fax Number : 309-588-4115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2012
Last Update Date : 01/25/2025

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Directions to “ MR. BRITAIN DUNAWAY MAC, LCPC” Practice Location

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