Provider Demographics
NPI:1740332188
Name:MONCRIEF, DONNA (LPC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:MONCRIEF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 RED HAWK CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4106
Mailing Address - Country:US
Mailing Address - Phone:817-263-6200
Mailing Address - Fax:817-263-6202
Practice Address - Street 1:7213 RED HAWK CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4106
Practice Address - Country:US
Practice Address - Phone:817-263-6200
Practice Address - Fax:817-263-6202
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17268101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10016284OtherAMERIGROUP