Provider Demographics
NPI:1164618641
Name:MONACO, DIANA (LMSW, CAADC,ADS)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:MONACO
Suffix:
Gender:F
Credentials:LMSW, CAADC,ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31205 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-1848
Mailing Address - Country:US
Mailing Address - Phone:586-213-1850
Mailing Address - Fax:586-846-4354
Practice Address - Street 1:31205 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-1848
Practice Address - Country:US
Practice Address - Phone:586-213-1850
Practice Address - Fax:586-846-4354
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010934241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical