Rex Bunnell, MLADC

Key facts

NPI

1326438698

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

License

0873 (NH)

Practice address

379 Pleasant Valley Rd
Wolfeboro, NH 03894-4437

Phone

(603) 387-9693

NPI assigned

Jan 26, 2015

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 26, 2015.

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1326438698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "WOLFEBORO FALLS",
            "state": "NH",
            "postal_code": "038960645",
            "telephone_number": "603-387-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 PLEASANT VALLEY RD",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "038944437",
            "telephone_number": "603-387-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNELL",
        "first_name": "REX",
        "credential": "MLADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Wolfeboro, NH · Addiction (Substance Use Disorder) Counselor in New Hampshire