Provider Demographics
NPI:1194293860
Name:BELLEFLEUR, MONIQUE ROSE (EDM, LMHC)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ROSE
Last Name:BELLEFLEUR
Suffix:
Gender:F
Credentials:EDM, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DANIELS RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-2704
Mailing Address - Country:US
Mailing Address - Phone:630-292-2618
Mailing Address - Fax:
Practice Address - Street 1:971 CONCORD ST STE 7
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4689
Practice Address - Country:US
Practice Address - Phone:508-969-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA10590OtherLMHC LICENSE