Provider Demographics
NPI:1073729398
Name:DESCAMPS, MONICA JANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:JANE
Last Name:DESCAMPS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-0583
Mailing Address - Country:US
Mailing Address - Phone:802-649-5499
Mailing Address - Fax:
Practice Address - Street 1:295 MAIN ST
Practice Address - Street 2:2ND FL
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-9321
Practice Address - Country:US
Practice Address - Phone:802-649-5499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048-0000740103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVN2952Medicare ID - Type Unspecified