Provider Demographics
NPI:1326843962
Name:BUNKLEMAN, MEGAN (LMFT-IT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BUNKLEMAN
Suffix:
Gender:
Credentials:LMFT-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5944 SEMINOLE CENTRE CT STE 210
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5019
Mailing Address - Country:US
Mailing Address - Phone:844-467-3467
Mailing Address - Fax:
Practice Address - Street 1:5944 SEMINOLE CENTRE CT STE 210
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5019
Practice Address - Country:US
Practice Address - Phone:844-467-3467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1138106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist