Provider Demographics
NPI:1477931806
Name:MONETTE, WINONAH CAMILLE (MSW, LAC, LICSW)
Entity Type:Individual
Prefix:
First Name:WINONAH
Middle Name:CAMILLE
Last Name:MONETTE
Suffix:
Gender:F
Credentials:MSW, LAC, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 S WASHINGTON ST STE C
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6339
Mailing Address - Country:US
Mailing Address - Phone:701-317-6590
Mailing Address - Fax:
Practice Address - Street 1:1913 S WASHINGTON ST STE C
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6339
Practice Address - Country:US
Practice Address - Phone:701-317-6590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305080101YA0400X
ND1721101YA0400X
MN499481041C0700X
ND50791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)