Provider Demographics
NPI:1306638440
Name:JANKUNAS, GEORGIA (LCPC-CANDIDATE)
Entity type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:
Last Name:JANKUNAS
Suffix:
Gender:F
Credentials:LCPC-CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S 3RD ST W APT 302
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-2537
Mailing Address - Country:US
Mailing Address - Phone:406-361-1911
Mailing Address - Fax:
Practice Address - Street 1:4095 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-6399
Practice Address - Country:US
Practice Address - Phone:406-361-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-79781101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health