Provider Demographics
NPI:1124484365
Name:VEGA, MONRETTA L (LPC, NCC)
Entity type:Individual
Prefix:
First Name:MONRETTA
Middle Name:L
Last Name:VEGA
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7540 MEMORIAL PKWY SW STE W
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2208
Mailing Address - Country:US
Mailing Address - Phone:256-824-9171
Mailing Address - Fax:256-824-9170
Practice Address - Street 1:7540 MEMORIAL PKWY SW STE W
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2208
Practice Address - Country:US
Practice Address - Phone:256-519-9144
Practice Address - Fax:256-519-9142
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3279101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional