Provider Demographics
NPI:1114576626
Name:MUNTER, CAROL HELENE (LP)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:HELENE
Last Name:MUNTER
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W 50TH ST APT 34E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6678
Mailing Address - Country:US
Mailing Address - Phone:917-318-5253
Mailing Address - Fax:
Practice Address - Street 1:350 W 50TH ST APT 34E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6678
Practice Address - Country:US
Practice Address - Phone:917-318-5253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000479-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst