Provider Demographics
NPI:1841081346
Name:JUNGE, KATHLEEN SUSAN (LICSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:SUSAN
Last Name:JUNGE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:LYNDEBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03082-0177
Mailing Address - Country:US
Mailing Address - Phone:603-654-3891
Mailing Address - Fax:
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-2464
Practice Address - Country:US
Practice Address - Phone:603-924-7462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH53081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical