Provider Demographics
NPI:1174355978
Name:JUNOD, COLETTE
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:
Last Name:JUNOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:COLETTE
Other - Middle Name:
Other - Last Name:SALGAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6902 INLET COVE DR
Mailing Address - Street 2:
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-7433
Mailing Address - Country:US
Mailing Address - Phone:571-585-1082
Mailing Address - Fax:
Practice Address - Street 1:6902 INLET COVE DR
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-7433
Practice Address - Country:US
Practice Address - Phone:571-585-1082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011186651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801118665OtherSTATE LICENSING NUMBER LCSW