Provider Demographics
NPI:1760806830
Name:MONROE, DESIREE CIERRA (LCPC)
Entity Type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:CIERRA
Last Name:MONROE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8274 KNIGHTHOOD PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3423
Mailing Address - Country:US
Mailing Address - Phone:301-938-0400
Mailing Address - Fax:
Practice Address - Street 1:8274 KNIGHTHOOD PL
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3423
Practice Address - Country:US
Practice Address - Phone:301-938-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD220024400Medicaid