Provider Demographics
NPI:1538657952
Name:MONET, CHANTAL MARIE
Entity Type:Individual
Prefix:
First Name:CHANTAL
Middle Name:MARIE
Last Name:MONET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHANTAL
Other - Middle Name:MARIE
Other - Last Name:ROMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2011 ATKINS AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-5448
Mailing Address - Country:US
Mailing Address - Phone:216-633-4920
Mailing Address - Fax:
Practice Address - Street 1:34900 CHARDON RD STE 203
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9161
Practice Address - Country:US
Practice Address - Phone:440-571-5270
Practice Address - Fax:440-571-4843
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1701783104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker