Provider Demographics
NPI:1396249421
Name:CODY, MONICA LORENE (MA, CADC-II)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LORENE
Last Name:CODY
Suffix:
Gender:F
Credentials:MA, CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 E 131ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-2725
Mailing Address - Country:US
Mailing Address - Phone:310-662-1077
Mailing Address - Fax:
Practice Address - Street 1:12917 CERISE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5520
Practice Address - Country:US
Practice Address - Phone:310-675-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA053860219101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)