Provider Demographics
NPI:1689941262
Name:HALTER, MONICA (APRN, PMHNP)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:HALTER
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24800 HIGHPOINT RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24800 HIGHPOINT RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6052
Practice Address - Country:US
Practice Address - Phone:216-831-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-26
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12939-NP363LP0808X
OHRN.319838-COA1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health