Provider Demographics
NPI:1902522618
Name:SANTIAGO, MONICA (LSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 VANDIKE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-1916
Mailing Address - Country:US
Mailing Address - Phone:267-345-8710
Mailing Address - Fax:
Practice Address - Street 1:833 N PARK RD STE 207
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1341
Practice Address - Country:US
Practice Address - Phone:484-709-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06349500104100000X
PASW134743104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker