Provider Demographics
NPI:1003042227
Name:BUNOVSKY, ELIZABETH LEAH (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:LEAH
Last Name:BUNOVSKY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 WEEKEEPEEMEE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-2002
Mailing Address - Country:US
Mailing Address - Phone:203-266-8063
Mailing Address - Fax:
Practice Address - Street 1:51 WEEKEEPEEMEE RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-2002
Practice Address - Country:US
Practice Address - Phone:203-263-7798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist