Provider Demographics
NPI:1922510999
Name:VANCE, MONICA (MSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:VANCE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 QUEEN STREET
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2473
Mailing Address - Country:US
Mailing Address - Phone:508-860-7930
Mailing Address - Fax:508-860-7989
Practice Address - Street 1:26 QUEEN STREET
Practice Address - Street 2:WORCESTER
Practice Address - City:MA
Practice Address - State:MA
Practice Address - Zip Code:01610-2473
Practice Address - Country:US
Practice Address - Phone:508-860-7930
Practice Address - Fax:508-860-7989
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1234891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical