Provider Demographics
NPI:1518383066
Name:JERNIGAN, MEGAN BUNCH (MS, LPCA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:BUNCH
Last Name:JERNIGAN
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:ANN
Other - Last Name:BUNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4745 GLOUCESTER DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-9322
Mailing Address - Country:US
Mailing Address - Phone:252-325-3049
Mailing Address - Fax:
Practice Address - Street 1:4745 GLOUCESTER DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-9322
Practice Address - Country:US
Practice Address - Phone:252-325-3049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-07
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC10705101YP2500X
NC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional