Provider Demographics
NPI:1720137672
Name:MONNIER, JEANNINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNINE
Middle Name:
Last Name:MONNIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 RUTLEDGE AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5835
Mailing Address - Country:US
Mailing Address - Phone:843-697-0867
Mailing Address - Fax:843-720-8500
Practice Address - Street 1:198 RUTLEDGE AVE STE 6
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5835
Practice Address - Country:US
Practice Address - Phone:843-697-0867
Practice Address - Fax:843-720-8500
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC714103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPS0308Medicaid
SCQ322440281Medicare UPIN