Provider Demographics
NPI:1700986882
Name:MUNDAY, JANAE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANAE
Middle Name:
Last Name:MUNDAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 E MISSOURI AVE
Mailing Address - Street 2:STE 830
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2726
Mailing Address - Country:US
Mailing Address - Phone:602-943-3611
Mailing Address - Fax:602-861-3511
Practice Address - Street 1:1130 E MISSOURI AVE
Practice Address - Street 2:STE 830
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2726
Practice Address - Country:US
Practice Address - Phone:602-943-3611
Practice Address - Fax:602-861-3511
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CSW2347IMedicare ID - Type Unspecified
R09173Medicare UPIN