Provider Demographics
NPI:1902522618
Name:SANTIAGO, MONICA (LCSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10871 BUSTLETON AVENUE PHILADELPHIA, PA, 191116
Mailing Address - Street 2:PMB #105
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1916
Mailing Address - Country:US
Mailing Address - Phone:484-532-8478
Mailing Address - Fax:
Practice Address - Street 1:10939 HELMER DR # 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-4113
Practice Address - Country:US
Practice Address - Phone:484-532-8478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06349500104100000X
PACW0256811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker