Provider Demographics
NPI:1154602555
Name:LUNDY, VIRGINIA E (LAPC)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:E
Last Name:LUNDY
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 SENECA CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2802
Mailing Address - Country:US
Mailing Address - Phone:404-604-7600
Mailing Address - Fax:
Practice Address - Street 1:406 SENECA CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-2802
Practice Address - Country:US
Practice Address - Phone:404-604-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002691101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional