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General NPI Number Information
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NPI Number | 1366321069
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Entity Type | Individual
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Provider Name | TRISTAN BROOKS MUNCHEL MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 623 ATWELLS AVE STE 201
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City | PROVIDENCE
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State | RI
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Zip | 02909-7403
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Country | US
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Telephone | 401-273-7103
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Fax |
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Provider Business Mailing Address
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Address Line | 225 KNIGHT ST APT 5
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City | PROVIDENCE
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State | RI
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Zip | 02909-1100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW04204
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License Number State | RI
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