Provider Demographics
NPI:1932856721
Name:POOLE, MONIKA (LLPC)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:POOLE
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 BLOSSOM RUN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-4542
Mailing Address - Country:US
Mailing Address - Phone:810-529-2731
Mailing Address - Fax:
Practice Address - Street 1:2425 S. LINDEN RD. SUITE D UNIT 104
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4853
Practice Address - Country:US
Practice Address - Phone:810-529-2731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health