Healthcare Provider Details

I. General information

NPI: 1568133015
Provider Name (Legal Business Name): JESSIE LEE MONAHAN LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSIE LEE BARNHART

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N MAIN ST
ADRIAN MI
49221-1759
US

IV. Provider business mailing address

8765 LEWIS AVE
TEMPERANCE MI
48182-9300
US

V. Phone/Fax

Practice location:
  • Phone: 734-847-3802
  • Fax:
Mailing address:
  • Phone: 517-263-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: