Provider Demographics
NPI:1982189908
Name:MONROE, NATOSHA KIMBERLY (LPC)
Entity Type:Individual
Prefix:
First Name:NATOSHA
Middle Name:KIMBERLY
Last Name:MONROE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 TOWN CENTER LN APT 2208
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2151
Mailing Address - Country:US
Mailing Address - Phone:817-657-2564
Mailing Address - Fax:
Practice Address - Street 1:201 MAIN ST STE 600
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3110
Practice Address - Country:US
Practice Address - Phone:817-657-2564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional