Provider Demographics
NPI:1154669125
Name:JUNGWIRTH, TONJA JEAN (MS, LPC-MH)
Entity Type:Individual
Prefix:MS
First Name:TONJA
Middle Name:JEAN
Last Name:JUNGWIRTH
Suffix:
Gender:F
Credentials:MS, LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:REDFIELD
Mailing Address - State:SD
Mailing Address - Zip Code:57469-1034
Mailing Address - Country:US
Mailing Address - Phone:605-460-1616
Mailing Address - Fax:
Practice Address - Street 1:115 W 7TH ST
Practice Address - Street 2:
Practice Address - City:REDFIELD
Practice Address - State:SD
Practice Address - Zip Code:57469-1034
Practice Address - Country:US
Practice Address - Phone:605-460-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2230101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health