Provider Demographics
NPI:1609359512
Name:CREMER, MONIQUE ANDREE (LICSW)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ANDREE
Last Name:CREMER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 E BUTTERFLY WAY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-3933
Mailing Address - Country:US
Mailing Address - Phone:401-475-3735
Mailing Address - Fax:
Practice Address - Street 1:4 E BUTTERFLY WAY
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-3933
Practice Address - Country:US
Practice Address - Phone:401-475-3735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1151941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical