Provider Demographics
NPI:1952653578
Name:MCJUNKIN, TAMARA JEAN (LPC, CRC)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:JEAN
Last Name:MCJUNKIN
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 CRESTVIEW CT
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-0941
Mailing Address - Country:US
Mailing Address - Phone:870-476-2259
Mailing Address - Fax:
Practice Address - Street 1:5755 RUFE SNOW DR STE 190
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6055
Practice Address - Country:US
Practice Address - Phone:870-476-2259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65730101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health