Provider Demographics
NPI:1194364406
Name:BLANCHETTE, MONICA ANNA (LMHC, RDT, APS)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ANNA
Last Name:BLANCHETTE
Suffix:
Gender:F
Credentials:LMHC, RDT, APS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 PUTNAM PIKE UNIT 7
Mailing Address - Street 2:
Mailing Address - City:CHEPACHET
Mailing Address - State:RI
Mailing Address - Zip Code:02814-1404
Mailing Address - Country:US
Mailing Address - Phone:401-773-7116
Mailing Address - Fax:
Practice Address - Street 1:712 PUTNAM PIKE UNIT 7
Practice Address - Street 2:
Practice Address - City:CHEPACHET
Practice Address - State:RI
Practice Address - Zip Code:02814-1404
Practice Address - Country:US
Practice Address - Phone:401-773-7116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC01018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health