Provider Demographics
NPI:1407019003
Name:BENNETT, MONICA JAYE (MPA, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:JAYE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MPA, LCSW
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:JAYE
Other - Last Name:GUIDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:719 S BURNSIDE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-3456
Mailing Address - Country:US
Mailing Address - Phone:225-281-2627
Mailing Address - Fax:
Practice Address - Street 1:719 S BURNSIDE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3456
Practice Address - Country:US
Practice Address - Phone:225-281-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA81151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical