Provider Demographics
NPI:1780697755
Name:MONAGHAN, LISA K (LISW MSW)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:K
Last Name:MONAGHAN
Suffix:
Gender:F
Credentials:LISW MSW
Other - Prefix:
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Mailing Address - Street 1:1055 E CENTERVILLE STATION RD
Mailing Address - Street 2:STE 200
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-5500
Mailing Address - Country:US
Mailing Address - Phone:937-439-2984
Mailing Address - Fax:937-439-2984
Practice Address - Street 1:1320 WOODMAN DR
Practice Address - Street 2:STE 200
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432
Practice Address - Country:US
Practice Address - Phone:937-223-1781
Practice Address - Fax:937-853-0096
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHI00075981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2272231Medicaid
OH2272231Medicaid
OH2272231Medicaid