Provider Demographics
NPI:1629789193
Name:MUNOZ, SUSANA NAVA (MED, LPC)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:NAVA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8408 DAVIS BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8610
Mailing Address - Country:US
Mailing Address - Phone:817-765-5664
Mailing Address - Fax:817-918-7307
Practice Address - Street 1:8408 DAVIS BLVD STE 240
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8610
Practice Address - Country:US
Practice Address - Phone:817-765-5664
Practice Address - Fax:817-918-7307
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88347101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty