Provider Demographics
NPI:1740412212
Name:PRICHARD, MONA (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:MONA
Middle Name:
Last Name:PRICHARD
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7668 FM 932
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:TX
Mailing Address - Zip Code:76531-3166
Mailing Address - Country:US
Mailing Address - Phone:254-386-5694
Mailing Address - Fax:
Practice Address - Street 1:206 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:GUSTINE
Practice Address - State:TX
Practice Address - Zip Code:76455
Practice Address - Country:US
Practice Address - Phone:325-667-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63547101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor