MEDICARE: VYATA MUNGUR MA, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	IMH15795	FL
2	101YM0800X	Mental Health Counselor	MH17904	FL

General Provider Information

NPI Number	:	1497268890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VYATA MUNGUR MA, LMHC

Provider Business Mailing Address
First Line	:	6065 39TH CT E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-7003
Country	:	US
Telephone Number	:	386-299-7937
Fax Number	:

Provider Business Practice Location Address
First Line	:	6065 39TH CT E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-7003
Country	:	US
Telephone Number	:	386-299-7937
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2017
Last Update Date	:	03/26/2025

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Directions to “ VYATA MUNGUR MA, LMHC” Practice Location

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