Provider Demographics
NPI:1598115503
Name:CHAMBERS, MONICA (MA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 N LOIS AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-2370
Mailing Address - Country:US
Mailing Address - Phone:813-897-8868
Mailing Address - Fax:
Practice Address - Street 1:2203 N LOIS AVE STE 220
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-2370
Practice Address - Country:US
Practice Address - Phone:813-897-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
GA011693101YM0800X
FL23426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor