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General NPI Number Information
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NPI Number | 1376706176
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Entity Type | Individual
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Provider Name | ELISE J. BOURGEOIS-MUNOZ DSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 235 MAIN ST STE 520
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City | WHITE PLAINS
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State | NY
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Zip | 10601
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Country | US
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Telephone | 914-533-4950
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Fax |
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Provider Business Mailing Address
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Address Line | 5441 WISHING ARCH DR
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City | APOLLO BEACH
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State | FL
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Zip | 33572-3466
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Country | US
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Telephone | 914-533-4950
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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 | CSW007777
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7571
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10728
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05972300
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C016090
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW21930
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 078824
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License Number State | NY
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