Provider Demographics
NPI:1669746376
Name:CHELETTE, MONICA VOLLM (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:VOLLM
Last Name:CHELETTE
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 1:3330 MASONIC DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3841
Mailing Address - Country:US
Mailing Address - Phone:318-899-5276
Mailing Address - Fax:318-899-5276
Practice Address - Street 1:17763 HIGHWAY 167
Practice Address - Street 2:
Practice Address - City:DRY PRONG
Practice Address - State:LA
Practice Address - Zip Code:71423-9205
Practice Address - Country:US
Practice Address - Phone:318-899-5276
Practice Address - Fax:318-899-5234
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA55941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical