Provider Demographics
NPI:1710095245
Name:BUNIAK, JUNE ELLEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:ELLEN
Last Name:BUNIAK
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 1:7505 PINELEAF PLACE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1703
Mailing Address - Country:US
Mailing Address - Phone:512-451-5618
Mailing Address - Fax:
Practice Address - Street 1:7505 PINELEAF PLACE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1703
Practice Address - Country:US
Practice Address - Phone:512-451-5618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
00S87GMedicare ID - Type Unspecified