Provider Demographics
NPI:1285915306
Name:MONCHUSIE, PETUNIA M (LPC, LCAC)
Entity type:Individual
Prefix:DR
First Name:PETUNIA
Middle Name:M
Last Name:MONCHUSIE
Suffix:
Gender:F
Credentials:LPC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15460 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2891
Mailing Address - Country:US
Mailing Address - Phone:913-748-7831
Mailing Address - Fax:
Practice Address - Street 1:15460 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2891
Practice Address - Country:US
Practice Address - Phone:913-748-7831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2280101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health