Provider Demographics
NPI:1164165023
Name:SONNER-PERRY, MONICA CHAN (LADC)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:CHAN
Last Name:SONNER-PERRY
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:CHAN
Other - Last Name:SONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:128 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5215
Mailing Address - Country:US
Mailing Address - Phone:614-914-0814
Mailing Address - Fax:
Practice Address - Street 1:400 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-1704
Practice Address - Country:US
Practice Address - Phone:207-405-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC7786101YA0400X
MELC7901101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)