Provider Demographics
NPI:1144500927
Name:DEROSIER, MONICA DE ANNE (QMHP, LCSW)
Entity type:Individual
Prefix:MISS
First Name:MONICA
Middle Name:DE ANNE
Last Name:DEROSIER
Suffix:
Gender:F
Credentials:QMHP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4606
Mailing Address - Country:US
Mailing Address - Phone:541-321-2278
Mailing Address - Fax:
Practice Address - Street 1:3085 RIVER RD N
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97303-6512
Practice Address - Country:US
Practice Address - Phone:541-321-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL111611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical