Provider Demographics
NPI:1164165023
Name:SONNER, MONICA CHAN (CADC)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:CHAN
Last Name:SONNER
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5215
Mailing Address - Country:US
Mailing Address - Phone:614-914-0814
Mailing Address - Fax:
Practice Address - Street 1:2 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-7537
Practice Address - Country:US
Practice Address - Phone:207-560-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC7786101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)