Provider Demographics
NPI:1851646160
Name:MUNICH, MATTHEW AARON (LICSW)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:AARON
Last Name:MUNICH
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2588
Mailing Address - Country:US
Mailing Address - Phone:617-545-3527
Mailing Address - Fax:617-524-7610
Practice Address - Street 1:11 GREEN ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2588
Practice Address - Country:US
Practice Address - Phone:617-545-3527
Practice Address - Fax:617-524-7610
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1181801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical