Provider Demographics
NPI:1790176345
Name:GASPER, MONICA (LPC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:GASPER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3167 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-6921
Mailing Address - Country:US
Mailing Address - Phone:520-222-6543
Mailing Address - Fax:
Practice Address - Street 1:3167 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-6921
Practice Address - Country:US
Practice Address - Phone:520-222-6543
Practice Address - Fax:520-366-3213
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-21503101YM0800X
AZLPC21503101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health