Provider Demographics
NPI:1740897370
Name:MUNGER, ALEXA MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:MARIE
Last Name:MUNGER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 N HALSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1818
Mailing Address - Country:US
Mailing Address - Phone:785-531-0997
Mailing Address - Fax:
Practice Address - Street 1:301 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:KS
Practice Address - Zip Code:67546-4618
Practice Address - Country:US
Practice Address - Phone:785-531-0997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03182-T106H00000X
KS03227106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist