Jerry Mungadze PHD.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

10315 Issued in TX

Legal business name

JERRY MUNGADZE PHD.

Practice address

2040 Bedford Rd
Suite 200
Bedford, TX 76021-5871

Phone

(817) 354-1389

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jerry J. Mungadze, PHD., LPCNPI 1356490080

Title

Owner

Phone

(817) 354-1389

Specialties & licenses 1

Addresses

Other names 1

• Mungadze and Associates Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry J. Mungadze, PHD., LPC

  • Mental Health Counselor
  • Bedford, TX
  • NPI 1356490080
  NPD (past) Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083786495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 BEDFORD RD",
            "address_2": "SUITE 200",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215871",
            "telephone_number": "817-354-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 BEDFORD RD",
            "address_2": "SUITE 200",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215871",
            "telephone_number": "817-354-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY MUNGADZE PHD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUNGADZE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-354-1389",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD., LPC"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TX",
            "license": "10315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mungadze and Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jcore Medical Diagnositcs
• Micki Jeffus
• Jennifer Catuncan OD PLLC
• Catherine Michelle Jennings, MD
• Jerry Latham OD PC
• Marisol Jimenez
• John a Hayes DDS PA
• John Barnett MD PA
• John David Miller, M.D.P.a.
• Elizabeth Mani John, MD

• Cognitive & Behavioral Psychologist in Bedford, TX
• Providers in Bedford, TX by specialty
• Cognitive & Behavioral Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.