Provider Demographics
NPI:1720120165
Name:JUNCK, VICKI (LPC)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:JUNCK
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 1:15711 BOUGAINVILLA LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-2913
Mailing Address - Country:US
Mailing Address - Phone:281-480-3683
Mailing Address - Fax:281-596-4548
Practice Address - Street 1:17000 EL CAMINO REAL
Practice Address - Street 2:STE.105E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2636
Practice Address - Country:US
Practice Address - Phone:281-480-3683
Practice Address - Fax:281-286-0776
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14151101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional