Provider Demographics
NPI:1265906028
Name:ISAAC, MONICA (ALMFT, LPC, NCC)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ISAAC
Suffix:
Gender:F
Credentials:ALMFT, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2714
Mailing Address - Country:US
Mailing Address - Phone:773-633-0557
Mailing Address - Fax:
Practice Address - Street 1:708 CHURCH ST STE 217
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3881
Practice Address - Country:US
Practice Address - Phone:773-633-0557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional