Provider Demographics
NPI:1558410209
Name:POLONYI, MONICA ANN (PHD, LPC-S)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:ANN
Last Name:POLONYI
Suffix:
Gender:F
Credentials:PHD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MOHAWK DRIVE
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1258
Mailing Address - Country:US
Mailing Address - Phone:936-856-7733
Mailing Address - Fax:
Practice Address - Street 1:250 ED ENGLISH DRIVE
Practice Address - Street 2:BLDG. 3 SUITE 4
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:936-295-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19204101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177447301Medicaid