Provider Demographics
NPI:1841369782
Name:PRIOR, MONDA SUE (MSW)
Entity type:Individual
Prefix:
First Name:MONDA
Middle Name:SUE
Last Name:PRIOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GRANITE STATE CT
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2127
Mailing Address - Country:US
Mailing Address - Phone:508-240-2921
Mailing Address - Fax:508-240-6521
Practice Address - Street 1:8 GRANITE STATE CT
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-2127
Practice Address - Country:US
Practice Address - Phone:508-240-2921
Practice Address - Fax:508-240-6521
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1035141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA013514OtherTUFT'S HEALTH
MA1894919Medicaid
MA0000P1720OtherBLUE CROSS BLUE SHIELD
MA1894919Medicaid