Provider Demographics
NPI:1104421981
Name:BRUNK, MARGARET DELEGAN (LCMHC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:DELEGAN
Last Name:BRUNK
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 LAUREL WAY
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-3532
Mailing Address - Country:US
Mailing Address - Phone:630-202-1037
Mailing Address - Fax:
Practice Address - Street 1:801 W MILLS ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-8494
Practice Address - Country:US
Practice Address - Phone:828-888-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15238101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional