Provider Demographics
NPI:1164565735
Name:BUNTING, BETH ANN (LCSW)
Entity type:Individual
Prefix:
First Name:BETH ANN
Middle Name:
Last Name:BUNTING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BETH ANN
Other - Middle Name:GRACE
Other - Last Name:JAVORNIK BUNTING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8607 HULL DR
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7539
Mailing Address - Country:US
Mailing Address - Phone:215-208-6350
Mailing Address - Fax:
Practice Address - Street 1:8607 HULL DR
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7539
Practice Address - Country:US
Practice Address - Phone:215-208-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW010139L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2358191000OtherPERSONAL CHOICE
PA174057000OtherMAGELLAN
PA7666257OtherAETNA