Provider Demographics
NPI:1841350188
Name:GOODRICH-PELLETIER, MONICA A (LMHC)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:A
Last Name:GOODRICH-PELLETIER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01521-2508
Mailing Address - Country:US
Mailing Address - Phone:413-245-7541
Mailing Address - Fax:
Practice Address - Street 1:35 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1245
Practice Address - Country:US
Practice Address - Phone:508-347-5403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health