Provider Demographics
NPI:1356620314
Name:MEHALSHICK, MONICA ROSE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ROSE
Last Name:MEHALSHICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6139 FOX RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-2511
Mailing Address - Country:US
Mailing Address - Phone:302-252-5277
Mailing Address - Fax:
Practice Address - Street 1:1820 COUNTY ROAD 36
Practice Address - Street 2:SERENITY LIGHT RECOVERY LLC
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515
Practice Address - Country:US
Practice Address - Phone:302-252-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61791171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor