Healthcare Provider Details

I. General information

NPI: 1134363138
Provider Name (Legal Business Name): MICAH MICHELLE MUNRO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 WINTHROP PL
NEW ORLEANS LA
70119-1921
US

IV. Provider business mailing address

122 WINTHROP PL
NEW ORLEANS LA
70119-1921
US

V. Phone/Fax

Practice location:
  • Phone: 303-887-3192
  • Fax:
Mailing address:
  • Phone: 303-887-3192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number362
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW023712
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number362
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18161
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: