Provider Demographics
NPI:1063167344
Name:MONTECILLO, MONIKA (LPC)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:MONTECILLO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 E WHITESTONE BLVD STE 2001
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-9078
Mailing Address - Country:US
Mailing Address - Phone:512-923-9900
Mailing Address - Fax:
Practice Address - Street 1:1436 BRAIDED ROPE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-4622
Practice Address - Country:US
Practice Address - Phone:512-923-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional