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NPI Code Detail

MEDICARE: CONSTANCE J JUNTUNEN L.C.S.W.

MEDICARE:   CONSTANCE J JUNTUNEN  L.C.S.W.
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
11041C0700XClinical Social Worker0904001928VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1187423-1185OTHERVAANTHEM HEALTHKEEPERS
2299067OTHERVAAMERIGROUP

General Provider Information

NPI Number : 1265450191
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONSTANCE J JUNTUNEN L.C.S.W.
Provider Business Mailing Address
First Line : 720 N SAINT ASAPH ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-1912
Country : US
Telephone Number : 703-838-6400
Fax Number : 703-838-5080
Provider Business Practice Location Address
First Line : 720 N SAINT ASAPH ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-1912
Country : US
Telephone Number : 703-838-6400
Fax Number : 703-838-5080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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Directions to “ CONSTANCE J JUNTUNEN L.C.S.W.” Practice Location

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