Provider Demographics
NPI:1154466985
Name:BUNCH, CAROL DENISE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:DENISE
Last Name:BUNCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8522 SIX FORKS RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3097
Mailing Address - Country:US
Mailing Address - Phone:919-801-3199
Mailing Address - Fax:
Practice Address - Street 1:8522 SIX FORKS RD
Practice Address - Street 2:SUITE 104
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3097
Practice Address - Country:US
Practice Address - Phone:919-801-3199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3529 LPC101YP2500X
NC3392101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)