Healthcare Provider Details

I. General information

NPI: 1861336570
Provider Name (Legal Business Name): HEATHER MUNDAY LCSWA, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 DARLINGTON AVE
WILMINGTON NC
28403-1343
US

IV. Provider business mailing address

4903 OLEANDER DR APT D
WILMINGTON NC
28403-5263
US

V. Phone/Fax

Practice location:
  • Phone: 910-782-8752
  • Fax:
Mailing address:
  • Phone: 910-231-6361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number101YA0400X
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1041C0700X
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: