Provider Demographics
NPI:1437127982
Name:LINTOTT, MONICA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:M
Last Name:LINTOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PARK ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-5907
Mailing Address - Country:US
Mailing Address - Phone:973-743-0105
Mailing Address - Fax:
Practice Address - Street 1:70 PARK ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5907
Practice Address - Country:US
Practice Address - Phone:973-743-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI3458103TC0700X
NJ35SI00345800103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ35SI00345800OtherNJ STATE LICENSE