Provider Demographics
NPI:1861845620
Name:BUNCH, ANNA MARIE (LPCC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:BUNCH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 CAMELOT DR APT 3
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-1711
Mailing Address - Country:US
Mailing Address - Phone:859-553-9030
Mailing Address - Fax:
Practice Address - Street 1:8650 PARK LAUREATE DR APT 216
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-7036
Practice Address - Country:US
Practice Address - Phone:859-583-5750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY161492101YP2500X
KY167756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional