Alyse Nanetta Munoz, EDD, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09924557 Issued in CO

Practice address

18313 Candice Dr
Triangle, VA 22172-1413

Phone

(720) 289-9116

NPI assigned

Oct 16, 2017

Last updated

May 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mentevo LLC

  • Clinical Social Worker
  • Triangle, VA
  • NPI 1124997549
  NPD Authorized official
• Holistic Functional Wellness Center, PLLC

  • Clinical Social Worker
  • Woodbridge, VA
  • NPI 1649032970
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1063923167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18313 CANDICE DR",
            "city": "TRIANGLE",
            "state": "VA",
            "postal_code": "221721413",
            "telephone_number": "720-289-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18313 CANDICE DR",
            "city": "TRIANGLE",
            "state": "VA",
            "postal_code": "221721413",
            "telephone_number": "720-289-9116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12910 Harbor Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221922930",
            "country_code": "US",
            "telephone_number": "703-740-8891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "ALYSE",
        "middle_name": "NANETTA",
        "name_prefix": "Dr.",
        "credential": "EDD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09924557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mentevo LLC
• Santana Patricia Miranda, RN L#0001310361
• MSRC One, LLC
• MSRC One, LLC
• MSRC One, LLC
• Maria Rosario Bustamante Nanoz
• Raissa Rella Ngwa Vemombih
• Novert Nyah
• Romanus L Nzengung
• Emeka Odom, OWNER

• Clinical Social Worker in Triangle, VA
• Providers in Triangle, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.