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General NPI Number Information
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NPI Number | 1780078824
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Entity Type | Individual
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Provider Name | LYDIA MUNOZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 3900 VENTNOR AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-5922
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Country | US
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Telephone | 609-345-1249
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Fax | 609-345-8533
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Provider Business Mailing Address
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Address Line | 303 SUMNER ST PO BOX 61
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City | LANDISVILLE
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State | NJ
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Zip | 08326-1521
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Country | US
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Telephone | 856-697-2967
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Fax | 856-697-0061
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SC00446700
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License Number State | NJ
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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 | 44SC00446700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 44SC00446700
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License Number State | NJ
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