Provider Demographics
NPI:1679189518
Name:CERLESI, MONICA RENEE (ACIT,)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:RENEE
Last Name:CERLESI
Suffix:
Gender:F
Credentials:ACIT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 ANGELA DR APT B
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46536-9215
Mailing Address - Country:US
Mailing Address - Phone:574-220-4522
Mailing Address - Fax:
Practice Address - Street 1:3006 LINCOLNWAY E
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-3501
Practice Address - Country:US
Practice Address - Phone:574-252-7233
Practice Address - Fax:844-361-2090
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)