Provider Demographics
NPI:1134691546
Name:MCCOMBS, MONICA (LMHC, LCPC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MCCOMBS
Suffix:
Gender:F
Credentials:LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6360 E MAIN ST APT 109
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-4683
Mailing Address - Country:US
Mailing Address - Phone:219-794-5280
Mailing Address - Fax:
Practice Address - Street 1:1012 W INDIANA ST
Practice Address - Street 2:
Practice Address - City:KOUTS
Practice Address - State:IN
Practice Address - Zip Code:46347-9703
Practice Address - Country:US
Practice Address - Phone:219-766-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-23
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003398A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health