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NPI Code Detail

MEDICARE: MRS. KIMBERLY L MUNN ADDICTION COUNSELOR

MEDICARE: MRS. KIMBERLY L MUNN ADDICTION COUNSELOR
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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) Counselor195491OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568502391
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY L MUNN ADDICTION COUNSELOR
Provider Business Mailing Address
First Line : 5577 AIRPORT HWY STE 200
Second Line :
City : TOLEDO
State : OH
Zip : 43615-7364
Country : US
Telephone Number : 419-720-0442
Fax Number :
Provider Business Practice Location Address
First Line : 5577 AIRPORT HWY STE 200
Second Line :
City : TOLEDO
State : OH
Zip : 43615-7364
Country : US
Telephone Number : 419-720-0442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 03/26/2026

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