Provider Demographics
NPI:1891140596
Name:EVRA, MONICA LYNN (MA, LPC)
Entity Type:Individual
Prefix:MISS
First Name:MONICA
Middle Name:LYNN
Last Name:EVRA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:130 VANN ST NE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8961
Mailing Address - Country:US
Mailing Address - Phone:678-919-1077
Mailing Address - Fax:678-317-3991
Practice Address - Street 1:130 VANN ST NE
Practice Address - Street 2:SUITE 220
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8961
Practice Address - Country:US
Practice Address - Phone:678-919-1077
Practice Address - Fax:678-317-3991
Is Sole Proprietor?:No
Enumeration Date:2016-05-01
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GALPC009435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional