Provider Demographics
NPI:1710064605
Name:BUNCH, LORI DRAKE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:DRAKE
Last Name:BUNCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HAZEL PATH STE 5
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3889
Mailing Address - Country:US
Mailing Address - Phone:615-824-7822
Mailing Address - Fax:
Practice Address - Street 1:102 HAZEL PATH STE 5
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3889
Practice Address - Country:US
Practice Address - Phone:615-824-7822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1635OtherLPC #