Annetta Dunklin

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LGPC11757 Issued in MD

Practice address

9015 Woodyard Rd Ste 208
Clinton, MD 20735-4209

Phone

(202) 780-6659

NPI assigned

Aug 13, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thrive Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Rosedale, MD
  • NPI 1053733378
  Medicare reassignment
• Thrive Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Silver Spring, MD
  • NPI 1306396163
  NPD
• Thrive Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1790156362
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1992470702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 541",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207180541",
            "telephone_number": "202-780-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD STE 208",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354209",
            "telephone_number": "202-780-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKLIN",
        "first_name": "ANNETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGPC11757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard G Drewyer, MD
• DRS. Roh, Park and Hwang, LLC
• DRS.Fernandez and Sriprasert P.a.
• Anne Sophia Ducroisy, CRNA
• Katrina Duncan, CASE MANAGER
• Sade Marie Dunn, LPC
• Emerald J'Nai Dupree, OTR/L
• Manisha Gonsalves Durkee, CRNP
• Dva Healthcare of Maryland LLC
• Dva Healthcare Renal Care Inc

• Professional Counselor in Clinton, MD
• Providers in Clinton, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.