Provider Demographics
NPI:1407073042
Name:MONROE, PATRICIA K (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:K
Last Name:MONROE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MOSSY OAKS LN
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-1713
Mailing Address - Country:US
Mailing Address - Phone:361-550-3086
Mailing Address - Fax:
Practice Address - Street 1:303 E AIRLINE RD STE 4
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3957
Practice Address - Country:US
Practice Address - Phone:361-880-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17385101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152238501Medicaid
TX112748201Medicaid
TX152238503Medicaid