MEDICARE: ALENKA MAY MUNGONYE-FAIRLEY CT

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	101YM0800X	Mental Health Counselor	C.2406309	OH
2	104100000X	Social Worker	C.2305084-TRNE	OH
3	101Y00000X	Counselor
4	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1780310441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALENKA MAY MUNGONYE-FAIRLEY CT

Provider Business Mailing Address
First Line	:	431 OHIO PIKE STE 312A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45255-3375
Country	:	US
Telephone Number	:	513-770-1705
Fax Number	:

Provider Business Practice Location Address
First Line	:	431 OHIO PIKE STE 312A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45255-3375
Country	:	US
Telephone Number	:	513-770-1705
Fax Number	:

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

Provider Enumeration Date	:	07/26/2022
Last Update Date	:	06/02/2026

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