Provider Demographics
NPI:1952840019
Name:MONSON, ANGIE JEAN (MS LMFT)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:JEAN
Last Name:MONSON
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11943 PEPPERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-5818
Mailing Address - Country:US
Mailing Address - Phone:218-251-5060
Mailing Address - Fax:
Practice Address - Street 1:25282 HAZELWOOD DR
Practice Address - Street 2:
Practice Address - City:NISSWA
Practice Address - State:MN
Practice Address - Zip Code:56468-2797
Practice Address - Country:US
Practice Address - Phone:218-961-4673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist