Provider Demographics
NPI:1265570501
Name:BUMGARNER, DENISE M (LPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:BUMGARNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BURNS RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7651
Mailing Address - Country:US
Mailing Address - Phone:540-658-0052
Mailing Address - Fax:
Practice Address - Street 1:2217 PRINCESS ANNE ST STE 327
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3353
Practice Address - Country:US
Practice Address - Phone:540-737-8120
Practice Address - Fax:540-322-2002
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA07010001829101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional