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NPI Code Detail

MEDICARE: ANTHONY BUNDY LPC

MEDICARE: ANTHONY BUNDY LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor6633LA
2101YP2500XProfessional Counselor89067TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588111751
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY BUNDY LPC
Provider Business Mailing Address
First Line : 711 COLONIAL DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6549
Country : US
Telephone Number : 225-246-2162
Fax Number :
Provider Business Practice Location Address
First Line : 711 COLONIAL DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6549
Country : US
Telephone Number : 225-246-2162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2016
Last Update Date : 10/21/2024

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Directions to “ ANTHONY BUNDY LPC” Practice Location

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