Individual provider Active NPI

Heidi Maria Muntjanoff, LCSW

  • Clinical Social Worker
  • Sycamore, IL
National Provider Identifier
1841379823
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
920 W Prairie Dr
Suite F
Sycamore, IL 60178-3123
Phone
(815) 899-0501
Fax
(815) 899-2098
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

920 W Prairie Dr
Suite F
Sycamore, IL 60178-3123

Mailing address

623 N 1St St Apt 2
Dekalb, IL 60115-3155
Phone (815) 756-2648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kishwaukee Community Hospital Past Accepting new patients
Timothy Tronc Counseling & Consulting LLC Clinical PastSince Apr 22, 2016 Accepting new patients
Kishwaukee Community Hospital Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841379823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 N 1ST ST APT 2",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601153155",
            "telephone_number": "815-756-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W PRAIRIE DR",
            "address_2": "SUITE F",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783123",
            "telephone_number": "815-899-0501",
            "fax_number": "815-899-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNTJANOFF",
        "first_name": "HEIDI",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.