Provider Demographics
NPI:1700291556
Name:MONA IDO LMHC, PA
Entity Type:Organization
Organization Name:MONA IDO LMHC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:IDO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:727-204-1573
Mailing Address - Street 1:7600 BRYAN DAIRY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1433
Mailing Address - Country:US
Mailing Address - Phone:727-266-4497
Mailing Address - Fax:866-597-4256
Practice Address - Street 1:7600 BRYAN DAIRY RD
Practice Address - Street 2:SUITE C
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1433
Practice Address - Country:US
Practice Address - Phone:727-266-4497
Practice Address - Fax:866-597-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty