Provider Demographics
NPI:1861931347
Name:FIELDS, MONICA DHULIA (LCSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:DHULIA
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:DHULIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:905 JOHNS HOPKINS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2056
Practice Address - Country:US
Practice Address - Phone:252-744-1406
Practice Address - Fax:252-744-2419
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2024-02-06
Deactivation Date:2020-11-16
Deactivation Code:
Reactivation Date:2020-11-24
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22701101YA0400X
NCP0105291041C0700X
NCC0120561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)