Provider Demographics
NPI:1942366505
Name:MONIC, MICHAEL FRANCIS (MA, LPC, LMFT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:MONIC
Suffix:
Gender:M
Credentials:MA, LPC, LMFT
Other - Prefix:
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Mailing Address - Street 1:714 N MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-5312
Mailing Address - Country:US
Mailing Address - Phone:337-824-5595
Mailing Address - Fax:337-824-5596
Practice Address - Street 1:714 N MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-5312
Practice Address - Country:US
Practice Address - Phone:337-824-5595
Practice Address - Fax:337-824-5596
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA2595101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional