Provider Demographics
NPI:1578958013
Name:SMITH, MONICA (MS)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:RICHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 WAPPING RD
Mailing Address - Street 2:
Mailing Address - City:BROAD BROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06016-9723
Mailing Address - Country:US
Mailing Address - Phone:860-559-0349
Mailing Address - Fax:
Practice Address - Street 1:915 SULLIVAN AVE STE 4A
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2165
Practice Address - Country:US
Practice Address - Phone:860-264-5675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health