Provider Demographics
NPI:1942674528
Name:ROMAN, MONICA (LPC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:C
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:234 W FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-1659
Mailing Address - Country:US
Mailing Address - Phone:414-305-8285
Mailing Address - Fax:
Practice Address - Street 1:234 W FLORIDA ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-1659
Practice Address - Country:US
Practice Address - Phone:414-305-8285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7118-125101YP2500X
WI2687-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional