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Jerry J. Mungadze, PHD,LPC
Mental Health Counselor in Bedford, Texas
NPI 1356490080

Jerry J. Mungadze is a Mental Health Counselor based in Bedford, TX and is specialized in Mental Health. Jerry J. Mungadze practices in Bedford, TX and has the professional credentials of PHD,LPC. The NPI Number for Jerry J. Mungadze is 1356490080 and holds a License No. 10315 (Texas).

The current practice location address for Jerry J. Mungadze is 2040 Bedford Rd Ste 200, Bedford, TX and can be reached out via phone at 817-354-1389.

Location: 2040 Bedford Rd Ste 200, Bedford, TX, 76021-5871
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356490080
Provider Name
Jerry J. Mungadze
Credential
PHD,LPC
Provider Entity Type
Individual
Gender
Male
Address
2040 Bedford Rd Ste 200, Bedford, TX, 76021-5871
Phone Number
817-354-1389
Fax Number
Provider Enumeration Date
01/10/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7323LC 01 TX BLUECROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
2040 Bedford Rd Ste 200
City
Bedford
State
Texas
Zip
76021-5871
Phone Number
817-354-1389
Fax Number
person
Provider Business Mailing Address Details
Address
2040 Bedford Rd Ste 200
City
Bedford
State
Texas
Zip
76021-5871
Phone Number
817-354-1389
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
10315 (Texas)
Definition
Definition to come...
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