1. Home
  2. Directory
  3. Texas
  4. Bedford
  5. Counselor
  6. NPI Profile

JERRY J. MUNGADZE PHD., LPC
NPI 1356490080
Counselor - Mental Health in Bedford, TX

Active since January 10, 2007
2040 BEDFORD RD STE 200, BEDFORD, TX 76021(817) 354-1389 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry J. Mungadze Phd., Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY J. MUNGADZE PHD., LPC (NPI 1356490080) is an individual mental health provider in Bedford, Texas, licensed in Texas (10315) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1356490080
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJERRY J. MUNGADZECredential: PHD., LPC
Location Address2040 BEDFORD RD STE 200Bedford, TX 76021-5871
Mailing Address2040 Bedford Rd Ste 200Bedford, TX 76021-5871 · (817) 354-1389
Phone(817) 354-1389
Sole ProprietorYes
Enumeration DateJanuary 10, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1356490080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in TX · 10315
2040 BEDFORD RD STE 200, Bedford, TX 76021
Open in Google Maps ↗

Other Identifiers 1

Other7323LCTX · Bluecross Blue Shield

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Mungadze's NPI number?

The NPI number for Jerry Mungadze is 1356490080. It was assigned to this individual provider in the NPPES registry on January 10, 2007.

Where is Jerry Mungadze located?

Jerry Mungadze practices at 2040 Bedford Rd Ste 200, Bedford, TX 76021. The listed phone number is (817) 354-1389.

What is Jerry Mungadze's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jerry Mungadze was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.