Provider Demographics
NPI:1740417690
Name:HARDING, MONICA ANNE
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:ANNE
Last Name:HARDING
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:ANNE
Other - Last Name:KALANEVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1105
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-1105
Mailing Address - Country:US
Mailing Address - Phone:443-624-0644
Mailing Address - Fax:
Practice Address - Street 1:12445 PAINTED HORSE TRL
Practice Address - Street 2:
Practice Address - City:LUSBY
Practice Address - State:MD
Practice Address - Zip Code:20657-3446
Practice Address - Country:US
Practice Address - Phone:443-624-0644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA207101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health