Provider Demographics
NPI:1689273120
Name:SHONTZ, MONIKA RAE (LCSWA)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:RAE
Last Name:SHONTZ
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6423 THE LAKES DR APT C
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3466
Mailing Address - Country:US
Mailing Address - Phone:941-525-3025
Mailing Address - Fax:
Practice Address - Street 1:3019 FALSTAFF RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1812
Practice Address - Country:US
Practice Address - Phone:919-250-7017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0148311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical