Provider Demographics
NPI:1629605415
Name:BUNCH, ERIN RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:RENEE
Last Name:BUNCH
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 1:1801 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-6044
Mailing Address - Country:US
Mailing Address - Phone:469-230-9230
Mailing Address - Fax:
Practice Address - Street 1:1801 MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-6044
Practice Address - Country:US
Practice Address - Phone:469-230-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX634841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX63484OtherLICENSE NUMBER