Provider Demographics
NPI:1609297233
Name:RICH-MCLAURIN, MONICA YNETTE
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:YNETTE
Last Name:RICH-MCLAURIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6372 EASTBROOKE
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1042
Mailing Address - Country:US
Mailing Address - Phone:313-595-2371
Mailing Address - Fax:248-671-0383
Practice Address - Street 1:6372 EASTBROOKE
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-1042
Practice Address - Country:US
Practice Address - Phone:313-595-2371
Practice Address - Fax:248-671-0383
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-27
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010929671041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical