Provider Demographics
NPI:1952984015
Name:ABBOTT, MONICA (CADAC II, MATS)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:CADAC II, MATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 MEIJER CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-4684
Mailing Address - Country:US
Mailing Address - Phone:765-701-6060
Mailing Address - Fax:765-701-6061
Practice Address - Street 1:4705 MEIJER CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4684
Practice Address - Country:US
Practice Address - Phone:765-701-6060
Practice Address - Fax:765-701-6061
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)