Provider Demographics
NPI:1093566911
Name:BUNN, PATRICIA (LCSWA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BUNN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 RAILROAD DR
Mailing Address - Street 2:
Mailing Address - City:NEW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27562-8959
Mailing Address - Country:US
Mailing Address - Phone:919-267-0567
Mailing Address - Fax:
Practice Address - Street 1:43 RAILROAD DR
Practice Address - Street 2:
Practice Address - City:NEW HILL
Practice Address - State:NC
Practice Address - Zip Code:27562-8959
Practice Address - Country:US
Practice Address - Phone:919-267-0567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0200581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical