Provider Demographics
NPI:1073812616
Name:BUNKE, REBECCA L (LGSW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:BUNKE
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:WINDSCHITL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:3737 40TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1772
Mailing Address - Country:US
Mailing Address - Phone:507-288-6978
Mailing Address - Fax:507-453-6267
Practice Address - Street 1:313 4TH ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4047
Practice Address - Country:US
Practice Address - Phone:608-796-1168
Practice Address - Fax:507-453-6267
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104100000X
MN201851041C0700X
WI81921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker