Healthcare Provider Details

I. General information

NPI: 1184998403
Provider Name (Legal Business Name): AARON EZEKIEL MUNSON LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2012
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15350 W NATIONAL AVE STE 108
NEW BERLIN WI
53151-5158
US

IV. Provider business mailing address

15350 W NATIONAL AVE STE 108
NEW BERLIN WI
53151-5158
US

V. Phone/Fax

Practice location:
  • Phone: 262-244-5352
  • Fax: 262-910-5477
Mailing address:
  • Phone: 262-244-5352
  • Fax: 262-910-5477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4749-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: