Provider Demographics
NPI:1942556584
Name:VAN HOOSE, MONROVIA C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MONROVIA
Middle Name:C
Last Name:VAN HOOSE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 LONGVIEW ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-4250
Mailing Address - Country:US
Mailing Address - Phone:512-529-3318
Mailing Address - Fax:
Practice Address - Street 1:2520 LONGVIEW ST
Practice Address - Street 2:SUITE 311
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4250
Practice Address - Country:US
Practice Address - Phone:512-529-3318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX524671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical