Provider Demographics
NPI:1578557062
Name:MONACO, LOUIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:MONACO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9171 WILSHIRE BLVD
Mailing Address - Street 2:#600
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5530
Mailing Address - Country:US
Mailing Address - Phone:310-666-7952
Mailing Address - Fax:
Practice Address - Street 1:9171 WILSHIRE BLVD
Practice Address - Street 2:#600
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5530
Practice Address - Country:US
Practice Address - Phone:310-666-7952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16252103TC0700X, 103TC2200X, 103TF0200X, 103T00000X
CAPSY 21425103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103T00000XBehavioral Health & Social Service ProvidersPsychologist