MEDICARE: NICHOLAS MUNK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PRS.007759	OH

General Provider Information

NPI Number	:	1063349744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS MUNK

Provider Business Mailing Address
First Line	:	402 E 307TH ST
Second Line	:
City	:	WILLOWICK
State	:	OH
Zip	:	44095-3726
Country	:	US
Telephone Number	:	440-283-9361
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 E GRANGER RD
Second Line	:
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-6704
Country	:	US
Telephone Number	:	888-586-7186
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ NICHOLAS MUNK ” Practice Location

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