Healthcare Provider Details

I. General information

NPI: 1164183083
Provider Name (Legal Business Name): ADAM MUNSICK LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6712 WASHINGTON AVE STE 105
EGG HARBOR TOWNSHIP NJ
08234-1999
US

IV. Provider business mailing address

762 SEASHORE RD
CAPE MAY NJ
08204-4649
US

V. Phone/Fax

Practice location:
  • Phone: 609-889-8100
  • Fax:
Mailing address:
  • Phone: 609-602-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01055600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number37AC00585500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: