Provider Demographics
NPI:1831390392
Name:MONETTE, CLEO B (LICSW)
Entity type:Individual
Prefix:MS
First Name:CLEO
Middle Name:B
Last Name:MONETTE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:ND
Mailing Address - Zip Code:58367-0088
Mailing Address - Country:US
Mailing Address - Phone:701-477-9050
Mailing Address - Fax:
Practice Address - Street 1:1102 MAIN AVE W
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:ND
Practice Address - Zip Code:58367-0088
Practice Address - Country:US
Practice Address - Phone:701-477-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND15111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical