Provider Demographics
NPI:1922735927
Name:FREW, MONICA LEIGH
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LEIGH
Last Name:FREW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5279 WALNUT VALLEY DR APT 1
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-2137
Mailing Address - Country:US
Mailing Address - Phone:508-340-9407
Mailing Address - Fax:
Practice Address - Street 1:1021 QUARRIER ST STE 310
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2338
Practice Address - Country:US
Practice Address - Phone:304-513-3900
Practice Address - Fax:304-988-4424
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical