Provider Demographics
NPI:1588183214
Name:MONICA L. BLAND, LCSW, LLC
Entity Type:Organization
Organization Name:MONICA L. BLAND, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-218-9341
Mailing Address - Street 1:2121 MIDPOINT DR STE 301B
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4342
Mailing Address - Country:US
Mailing Address - Phone:970-218-9341
Mailing Address - Fax:970-797-1258
Practice Address - Street 1:2121 MIDPOINT DR STE 301B
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4342
Practice Address - Country:US
Practice Address - Phone:970-218-9341
Practice Address - Fax:970-797-1258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099241781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty