Provider Demographics
NPI:1316698541
Name:SUMMERS, BRIANNA D (LGPC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:D
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 BALTIMORE PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4212
Mailing Address - Country:US
Mailing Address - Phone:443-907-1707
Mailing Address - Fax:
Practice Address - Street 1:802 BALTIMORE PIKE STE 102
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4212
Practice Address - Country:US
Practice Address - Phone:443-907-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLG11168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health