Provider Demographics
NPI:1013686336
Name:MUNOZ, KENNETH (MSW)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N COUNTY ST STE 400L
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-4321
Mailing Address - Country:US
Mailing Address - Phone:773-581-4357
Mailing Address - Fax:773-498-7186
Practice Address - Street 1:33 N COUNTY ST STE 400L
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-4321
Practice Address - Country:US
Practice Address - Phone:773-581-4357
Practice Address - Fax:773-498-7186
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health