Provider Demographics
NPI:1538625272
Name:MUNYIRI, CHEGE STEPHEN I (PHD)
Entity type:Individual
Prefix:
First Name:CHEGE
Middle Name:STEPHEN
Last Name:MUNYIRI
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6856 CANDLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1793
Mailing Address - Country:US
Mailing Address - Phone:205-382-2574
Mailing Address - Fax:
Practice Address - Street 1:6856 CANDLEWOOD LN
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1793
Practice Address - Country:US
Practice Address - Phone:205-382-2574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC29969A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000OtherN/A