MEDICARE: JOAN ANN JUNGINGER LCSW

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
1	1041C0700X	Clinical Social Worker	C003897	NC

General Provider Information

NPI Number	:	1427034719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN ANN JUNGINGER LCSW

Provider Business Mailing Address
First Line	:	2402 FLINTS POND CIR
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27523-4801
Country	:	US
Telephone Number	:	919-924-3124
Fax Number	:

Provider Business Practice Location Address
First Line	:	2402 FLINTS POND CIR
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27523-4801
Country	:	US
Telephone Number	:	919-924-3124
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	07/08/2007

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