Provider Demographics
NPI:1386397784
Name:BUNT, MATTHEW A (LPC-S)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:A
Last Name:BUNT
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5705 DORCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-3408
Mailing Address - Country:US
Mailing Address - Phone:205-607-2320
Mailing Address - Fax:
Practice Address - Street 1:5705 DORCHESTER WAY
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-3408
Practice Address - Country:US
Practice Address - Phone:205-607-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2876101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor