Provider Demographics
NPI:1598823650
Name:MUNSON, DANIEL CHARLES (LMFT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHARLES
Last Name:MUNSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 COUNTY ROAD D E
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5353
Mailing Address - Country:US
Mailing Address - Phone:651-748-5019
Mailing Address - Fax:651-773-7591
Practice Address - Street 1:2006 1ST AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2290
Practice Address - Country:US
Practice Address - Phone:763-421-5535
Practice Address - Fax:763-433-0226
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1159106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN191L6MUOtherBLUE CROSS BLUE SHIELD
MN6269294OtherUBH - MEDICA
MNHP40373OtherHEALTH PARTNERS