Healthcare Provider Details

I. General information

NPI: 1699381467
Provider Name (Legal Business Name): MONIQUE GASTON LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 10/12/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WELL LIFE COUNSELING AND CONSULTING 9649 BELAIR ROAD, STE. 104
NOTTINGHAM MD
21236
US

IV. Provider business mailing address

DEPARTMENT OF VETERANS AFFAIRS 50 IRVING STREET NW
WASHINGTON DC
20422
US

V. Phone/Fax

Practice location:
  • Phone: 410-529-1309
  • Fax: 410-529-1005
Mailing address:
  • Phone: 202-745-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: