Provider Demographics
NPI:1639299860
Name:MUNYAN, MICHELLE (MA LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MUNYAN
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:DEL MONTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA LPC
Mailing Address - Street 1:500 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2135
Mailing Address - Country:US
Mailing Address - Phone:908-725-2800
Mailing Address - Fax:908-704-1790
Practice Address - Street 1:500 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2135
Practice Address - Country:US
Practice Address - Phone:908-725-2800
Practice Address - Fax:908-704-1790
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00356500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023701Medicaid
NJ527486Medicare ID - Type UnspecifiedAGENCY PROVIDER #