Shelley Jan Bunn, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A18628 Issued in NC

Practice address

609 Piner Rd.
Suite a #552
Wilmington, NC 28409

Phone

(360) 903-5895

NPI assigned

Sep 3, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1285941724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 PINER RD.",
            "address_2": "SUITE A #552",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28409",
            "telephone_number": "360-903-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 PINER RD.",
            "address_2": "SUITE A #552",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28409",
            "telephone_number": "360-903-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN",
        "first_name": "SHELLEY",
        "middle_name": "JAN",
        "name_prefix": "Mrs.",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2023-05-04",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61389889",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Bullard, LMFTA
• Paula Sellers Bullock, CRNA
• Rebecca Frances Bulut
• Maria Bumbalo, SLP
• Samantha Jean Bunge, DC
• Taylor Pilar Bunn, MS
• Elizabeth McNeill Bunting, DSC, PA-C
• Jane Vogt Buongiorno, PH.D.
• Paul Anthony Buongiorno, M.D.
• Linda W Burbank, MSW LCSW

• Mental Health Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.