Provider Demographics
NPI:1215000617
Name:JUNTUNEN, CINDY LEE (LP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:LEE
Last Name:JUNTUNEN
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:LEE
Other - Last Name:JUNTUNEN SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2718 BELMONT RD
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 N COLUMBIA RD STOP 7132
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-2817
Practice Address - Country:US
Practice Address - Phone:701-777-3745
Practice Address - Fax:701-777-3845
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
ND276103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12862Medicaid
ND13688OtherBCBSND
ND61-77037OtherMEDICA UBH
MN8H898JUOtherBCBSMN
MN195023100Medicaid
ND58203-A002OtherTRIWEST