Provider Demographics
NPI:1720607500
Name:MERTENS, MONICA LOUISE (LPCC)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:LOUISE
Last Name:MERTENS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 E OHIO PIKE # L0T224
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-2017
Mailing Address - Country:US
Mailing Address - Phone:513-314-3492
Mailing Address - Fax:
Practice Address - Street 1:3973 HOPPER HILL RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4945
Practice Address - Country:US
Practice Address - Phone:513-314-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty