Provider Demographics
NPI:1750865895
Name:ALLEN, MONIQUE STONE (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:STONE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 VENUS RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-9168
Mailing Address - Country:US
Mailing Address - Phone:910-546-6590
Mailing Address - Fax:
Practice Address - Street 1:110 BRANCHWOOD DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5900
Practice Address - Country:US
Practice Address - Phone:910-938-9833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0113901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical