Provider Demographics
NPI:1285089839
Name:MUNTZ, ADRIANNE (LLMSW)
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:
Last Name:MUNTZ
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29195 TESSMER CT
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-2603
Mailing Address - Country:US
Mailing Address - Phone:248-794-9994
Mailing Address - Fax:
Practice Address - Street 1:51145 WASHINGTON ST
Practice Address - Street 2:SUITE E
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-2100
Practice Address - Country:US
Practice Address - Phone:586-604-9101
Practice Address - Fax:586-690-4902
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010991221041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health