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NPI Code Detail

MEDICARE: MR. JOHN CHARLES BUNGARD LPC

MEDICARE: MR. JOHN CHARLES BUNGARD 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
1101Y00000XCounselor0701002574VA
2101YM0800XMental Health Counselor0701002574VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1087539OTHERVASENTARA/OPTIMA
2381197OTHERVAANTHEM BC/BS

General Provider Information

NPI Number : 1033115845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN CHARLES BUNGARD LPC
Provider Business Mailing Address
First Line : 1241 N MAIN ST
Second Line :
City : HARRISONBURG
State : VA
Zip : 22802-4632
Country : US
Telephone Number : 540-433-3100
Fax Number : 540-432-6989
Provider Business Practice Location Address
First Line : 463 E WASHINGTON ST
Second Line :
City : HARRISONBURG
State : VA
Zip : 22802-4853
Country : US
Telephone Number : 540-433-3100
Fax Number : 540-432-6989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 09/11/2025

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