Provider Demographics
NPI:1003539537
Name:BUMGARNER, CHRISTOPHER AARON (LCMHCA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:AARON
Last Name:BUMGARNER
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 4TH CREEK LANDING DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-8270
Mailing Address - Country:US
Mailing Address - Phone:828-499-1475
Mailing Address - Fax:
Practice Address - Street 1:255 18TH ST SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1364
Practice Address - Country:US
Practice Address - Phone:828-327-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18078101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health