Provider Demographics
NPI:1558442897
Name:BUNKER, MEG RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:MEG
Middle Name:RENEE
Last Name:BUNKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10369 DEMOCRACY LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2548
Mailing Address - Country:US
Mailing Address - Phone:703-293-7090
Mailing Address - Fax:703-293-7091
Practice Address - Street 1:10369 DEMOCRACY LN
Practice Address - Street 2:SUITE B
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2548
Practice Address - Country:US
Practice Address - Phone:703-293-7090
Practice Address - Fax:703-293-7091
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical