Provider Demographics
NPI:1932730017
Name:NGO, MONIQUE H (MA, LMFT-A, LMHC-A)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:H
Last Name:NGO
Suffix:
Gender:F
Credentials:MA, LMFT-A, LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 22ND ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-3442
Mailing Address - Country:US
Mailing Address - Phone:253-325-1379
Mailing Address - Fax:
Practice Address - Street 1:1345 22ND ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-3442
Practice Address - Country:US
Practice Address - Phone:253-325-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61022477106H00000X
WA61022475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health