Provider Demographics
NPI:1376867952
Name:DEAN, MONICA E (CASAC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:E
Last Name:DEAN
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12037-1321
Mailing Address - Country:US
Mailing Address - Phone:518-392-6347
Mailing Address - Fax:
Practice Address - Street 1:3 MERCYCARE LN
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-3504
Practice Address - Country:US
Practice Address - Phone:518-452-6749
Practice Address - Fax:518-452-6756
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17404101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)