Provider Demographics
NPI:1184945032
Name:HEBERT, MONIQUE ALEXZENIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:ALEXZENIA
Last Name:HEBERT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 JEFFERSON AVE
Mailing Address - Street 2:PH
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-1610
Mailing Address - Country:US
Mailing Address - Phone:347-733-4147
Mailing Address - Fax:347-332-1748
Practice Address - Street 1:583 JEFFERSON AVE
Practice Address - Street 2:PH
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1610
Practice Address - Country:US
Practice Address - Phone:347-733-4147
Practice Address - Fax:347-332-1748
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07898-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker