Provider Demographics
NPI:1053502674
Name:BIRSEN, MONICA A (LPCC-S)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:A
Last Name:BIRSEN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 REYNOLDS RD STE 301
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1634
Mailing Address - Country:US
Mailing Address - Phone:419-340-7706
Mailing Address - Fax:419-932-6657
Practice Address - Street 1:1446 REYNOLDS RD STE 301
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1634
Practice Address - Country:US
Practice Address - Phone:419-340-7706
Practice Address - Fax:419-932-6657
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0004169101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor