Provider Demographics
NPI:1265616148
Name:BUNDY, VALERIE ELIZABETH (LPC NCC)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:ELIZABETH
Last Name:BUNDY
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8180 S MINNEHAHA ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97136-9766
Mailing Address - Country:US
Mailing Address - Phone:503-927-5350
Mailing Address - Fax:
Practice Address - Street 1:8180 S MINNEHAHA ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:OR
Practice Address - Zip Code:97136-9766
Practice Address - Country:US
Practice Address - Phone:503-927-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3272101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor