Provider Demographics
NPI:1154769461
Name:ECHOLS, MONICA SUE (LPCA)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:SUE
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 DUNKIRK LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-1205
Mailing Address - Country:US
Mailing Address - Phone:502-544-8155
Mailing Address - Fax:
Practice Address - Street 1:7311 DUNKIRK LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-1205
Practice Address - Country:US
Practice Address - Phone:502-544-8155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-08
Last Update Date:2013-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1594101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional