Monroe, Linda

Monroe, Linda is an sole proprietor health care provider with primary practice located at 2410 Grape Rd Ste 1 , Mishawaka IN 46545-3015. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Monroe, Linda can be contacted via phone (574) 243-9370.

Contact Information

Primary practice address
2410 Grape Rd Ste 1 Mishawaka IN 46545-3015
Fax: (574) 243-9375
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301011586 Michigan
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20040361A Indiana

Profile Details

NPI number 1003983115
LBN Legal business name Monroe, Linda
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2006
Last updated Dec 13th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003983115 NPPES
Indiana Other 351877953 TRICARE PROVIDER NUMBER
Indiana MEDICAID 100091350C TRICARE PROVIDER NUMBER

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