Provider Demographics
NPI:1922292127
Name:LUNSFORD, JANICE IRENE (BSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:IRENE
Last Name:LUNSFORD
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-3233
Mailing Address - Country:US
Mailing Address - Phone:580-364-0330
Mailing Address - Fax:580-889-4842
Practice Address - Street 1:1501 S VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-3233
Practice Address - Country:US
Practice Address - Phone:580-364-0330
Practice Address - Fax:580-889-4842
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)