Provider Demographics
NPI:1780755983
Name:BUNDICK, DENISE QUIRK (LCSW)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:QUIRK
Last Name:BUNDICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8216 CREEDMOOR RD STE 101
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1391
Mailing Address - Country:US
Mailing Address - Phone:919-870-0264
Mailing Address - Fax:866-777-4638
Practice Address - Street 1:8216 CREEDMOOR RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1391
Practice Address - Country:US
Practice Address - Phone:919-870-0264
Practice Address - Fax:866-777-4638
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0047841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical