Provider Demographics
NPI:1902210941
Name:MCNEILL, MONICA LAVETTE (LPC-A)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LAVETTE
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12910 MOSBY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4838
Mailing Address - Country:US
Mailing Address - Phone:704-290-8779
Mailing Address - Fax:
Practice Address - Street 1:12910 MOSBY LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4838
Practice Address - Country:US
Practice Address - Phone:704-290-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional