Provider Demographics
NPI:1962049726
Name:MONROE, CHARLOTTE SUZETTE
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:SUZETTE
Last Name:MONROE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SCARLET OAK DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-6430
Mailing Address - Country:US
Mailing Address - Phone:910-978-2003
Mailing Address - Fax:
Practice Address - Street 1:6977 NEXUS CT STE 102
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2651
Practice Address - Country:US
Practice Address - Phone:910-703-8402
Practice Address - Fax:910-703-8672
Is Sole Proprietor?:No
Enumeration Date:2019-11-28
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical