Provider Demographics
NPI:1992851992
Name:MONAHAN, SUSAN MINJUNG (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MINJUNG
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:MONAHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW,LCSW
Mailing Address - Street 1:950 WADSWORTH BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4591
Mailing Address - Country:US
Mailing Address - Phone:303-257-7047
Mailing Address - Fax:303-996-0663
Practice Address - Street 1:950 WADSWORTH BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4591
Practice Address - Country:US
Practice Address - Phone:303-257-7047
Practice Address - Fax:303-996-0663
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO991776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health