Provider Demographics
NPI:1215008800
Name:MONK, MARY LOUISE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LOUISE
Last Name:MONK
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:LOU
Other - Last Name:MONK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:134 BROAD ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-1590
Mailing Address - Country:US
Mailing Address - Phone:570-421-7868
Mailing Address - Fax:570-421-7820
Practice Address - Street 1:134 BROAD ST
Practice Address - Street 2:SUITE 7
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1590
Practice Address - Country:US
Practice Address - Phone:570-421-7868
Practice Address - Fax:570-421-7820
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker