Provider Demographics
NPI:1174838106
Name:LEVESQUE, MONICCA C (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MONICCA
Middle Name:C
Last Name:LEVESQUE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 POND RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-4015
Mailing Address - Country:US
Mailing Address - Phone:603-490-2229
Mailing Address - Fax:
Practice Address - Street 1:80 NASHUA RD
Practice Address - Street 2:SUITE B-2
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3426
Practice Address - Country:US
Practice Address - Phone:603-818-8926
Practice Address - Fax:603-818-8928
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist