Provider Demographics
NPI:1538999719
Name:CHADWICK, MONIQUE ERIKA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:ERIKA
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11512 CASA MARINA WAY APT 203
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-6359
Mailing Address - Country:US
Mailing Address - Phone:813-580-3327
Mailing Address - Fax:
Practice Address - Street 1:615 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5714
Practice Address - Country:US
Practice Address - Phone:813-565-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-03
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health