Provider Demographics
NPI:1871701953
Name:PADULA, MONICA S (LISW, LIMFT, PHD-C)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:S
Last Name:PADULA
Suffix:
Gender:F
Credentials:LISW, LIMFT, PHD-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 W MARKET ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3324
Mailing Address - Country:US
Mailing Address - Phone:330-459-6743
Mailing Address - Fax:
Practice Address - Street 1:2014 FARNHAM N
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-2916
Practice Address - Country:US
Practice Address - Phone:954-257-4469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF0500045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist