Provider Demographics
NPI:1275712895
Name:IBARRA, MONICA (LCSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:IBARRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:559 VINCENT ST.
Mailing Address - Street 2:ATTN: 21 MDOS/SGOW - FAMILY ADVOCACY
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914
Mailing Address - Country:US
Mailing Address - Phone:719-556-8943
Mailing Address - Fax:877-813-1756
Practice Address - Street 1:559 VINCENT ST.
Practice Address - Street 2:ATTN: 21 MDOS/SGOW - FAMILY ADVOCACY
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914
Practice Address - Country:US
Practice Address - Phone:719-556-8943
Practice Address - Fax:877-813-1756
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6465101YA0400X
CO8851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)