Provider Demographics
NPI:1720556442
Name:STRUNK, CAROLINE YUMI
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:YUMI
Last Name:STRUNK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6202 WINNEPEG DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3848
Mailing Address - Country:US
Mailing Address - Phone:703-340-6462
Mailing Address - Fax:
Practice Address - Street 1:1751 PINNACLE DR STE 600
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4007
Practice Address - Country:US
Practice Address - Phone:703-340-6462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE