Provider Demographics
NPI:1487611414
Name:MONUTEAUX, THERESA ELENA (MSW LICSW)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ELENA
Last Name:MONUTEAUX
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SULLIVAN DR
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-6812
Mailing Address - Country:US
Mailing Address - Phone:508-523-4792
Mailing Address - Fax:508-646-9556
Practice Address - Street 1:101 SULLIVAN DR
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-6812
Practice Address - Country:US
Practice Address - Phone:508-523-4792
Practice Address - Fax:508-646-9556
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10195241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1035720OtherBEACON HEALTH
MAP06134OtherBC
MA014756OtherVALUE OPTIONS
MA101954OtherTUFTS TOTAL HEALTH
MA408300OtherMAGELLAN
RI267988OtherBCRI
MA014756OtherHARVARD PILGRIM
MA1890964OtherMA BEHAVIORA HEALTH
MA014756OtherHARVARD PILGRIM