Provider Demographics
NPI:1528932118
Name:BIRD MUNOZ, GONZALO NICOLAS (LSW)
Entity type:Individual
Prefix:
First Name:GONZALO
Middle Name:NICOLAS
Last Name:BIRD MUNOZ
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:GONZALO
Other - Middle Name:
Other - Last Name:BIRD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:5880 ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1793
Mailing Address - Country:US
Mailing Address - Phone:412-444-8340
Mailing Address - Fax:
Practice Address - Street 1:5880 ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1793
Practice Address - Country:US
Practice Address - Phone:412-444-8340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW143400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker