Provider Demographics
NPI:1245954015
Name:BUONGIOVANNI HUNT, LAUREN (APC008185)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BUONGIOVANNI HUNT
Suffix:
Gender:F
Credentials:APC008185
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4326
Mailing Address - Country:US
Mailing Address - Phone:423-653-6848
Mailing Address - Fax:
Practice Address - Street 1:675 SEMINOLE AVE NE STE 111
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-3412
Practice Address - Country:US
Practice Address - Phone:678-400-9477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008185101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty