MEDICARE: WILLIAM MICHAEL MUNION MA, LPC

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	106H00000X	Marriage & Family Therapist	LPC0798	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LPC0798	OTHER	AZ	STATE LICENSE

General Provider Information

NPI Number	:	1063638179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MICHAEL MUNION MA, LPC

Provider Business Mailing Address
First Line	:	1052 E HALIFAX ST
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-3726
Country	:	US
Telephone Number	:	480-250-7895
Fax Number	:	480-964-3839

Provider Business Practice Location Address
First Line	:	4140 E BASELINE RD STE 101
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4413
Country	:	US
Telephone Number	:	802-507-8954
Fax Number	:	480-964-3839

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	01/28/2025

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