Healthcare Provider Details

I. General information

NPI: 1366953093
Provider Name (Legal Business Name): MONICA JEAN SUTTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA JEAN MCCORMICK

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 PROGRESS WAY STE 101
WAUNAKEE WI
53597-2520
US

IV. Provider business mailing address

251 PROGRESS WAY STE 101
WAUNAKEE WI
53597-2520
US

V. Phone/Fax

Practice location:
  • Phone: 608-849-5430
  • Fax:
Mailing address:
  • Phone: 608-849-5430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9575-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: