Provider Demographics
NPI:1215275060
Name:PRESTON, MONIKA EMMA (LCPC)
Entity type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:EMMA
Last Name:PRESTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 CHURCHILL RD APT F
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-6401
Mailing Address - Country:US
Mailing Address - Phone:443-655-4611
Mailing Address - Fax:
Practice Address - Street 1:900 S MAIN ST BLDG A
Practice Address - Street 2:SUITE 105
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5447
Practice Address - Country:US
Practice Address - Phone:410-914-4012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional