Provider Demographics
NPI:1851138556
Name:HARRELSON, MONICA SABRINA (LCSW-A)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:SABRINA
Last Name:HARRELSON
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 PARKERSBURG ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-6656
Mailing Address - Country:US
Mailing Address - Phone:919-622-0692
Mailing Address - Fax:
Practice Address - Street 1:3109 PARKERSBURG ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-6656
Practice Address - Country:US
Practice Address - Phone:919-622-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0193821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical