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NPI Code Detail

MEDICARE: JENNIFER M MUNKSGARD LCSW

MEDICARE: JENNIFER M MUNKSGARD LCSW
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker081173NY
31041C0700XClinical Social WorkerCW018558PA

General Provider Information

NPI Number : 1619267127
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER M MUNKSGARD LCSW
Provider Business Mailing Address
First Line : 1048 PENNSYLVANIA AVE W
Second Line :
City : WARREN
State : PA
Zip : 16365-1838
Country : US
Telephone Number : 814-230-9111
Fax Number : 814-313-1075
Provider Business Practice Location Address
First Line : 1048 PENNSYLVANIA AVE W
Second Line :
City : WARREN
State : PA
Zip : 16365-1838
Country : US
Telephone Number : 814-230-9111
Fax Number : 814-313-1075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2011
Last Update Date : 08/06/2025

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