Provider Demographics
NPI:1245413400
Name:JOEL T JUNKER MA, LTD
Entity Type:Organization
Organization Name:JOEL T JUNKER MA, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:JUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:719-578-8664
Mailing Address - Street 1:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-0846
Mailing Address - Country:US
Mailing Address - Phone:719-578-8664
Mailing Address - Fax:719-481-8210
Practice Address - Street 1:611 N WEBER ST
Practice Address - Street 2:SUITE 302
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1032
Practice Address - Country:US
Practice Address - Phone:719-578-8664
Practice Address - Fax:719-481-8210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty