Provider Demographics
NPI:1235146838
Name:MUNDAY, JAN MAREE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:MAREE
Last Name:MUNDAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 W DALY ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-8232
Mailing Address - Country:US
Mailing Address - Phone:406-310-0258
Mailing Address - Fax:406-723-5345
Practice Address - Street 1:305 W MERCURY ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1659
Practice Address - Country:US
Practice Address - Phone:406-723-5489
Practice Address - Fax:406-723-4020
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical