Provider Demographics
NPI:1154102184
Name:INGHAM, MONICA MARIE
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIE
Last Name:INGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 E GIRARD PL APT 1235A
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-9130
Mailing Address - Country:US
Mailing Address - Phone:814-215-8344
Mailing Address - Fax:
Practice Address - Street 1:4643 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3305
Practice Address - Country:US
Practice Address - Phone:303-463-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty