Provider Demographics
NPI:1871020057
Name:HAAS, MONIQUE M (PLPC)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:M
Last Name:HAAS
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-1410
Mailing Address - Country:US
Mailing Address - Phone:816-508-3569
Mailing Address - Fax:816-508-3535
Practice Address - Street 1:3100 NE 83RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-4400
Practice Address - Country:US
Practice Address - Phone:816-508-3400
Practice Address - Fax:816-508-3421
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017014816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health