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General NPI Number Information
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NPI Number | 1033484381
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Entity Type | Individual
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Provider Name | MONIQUE A MORT LPC
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Gender | Female
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 6344 E BROADWAY RD STE 107
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City | MESA
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State | AZ
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Zip | 85206-1634
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Country | US
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Telephone | 602-888-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 6344 E BROADWAY RD STE 107
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City | MESA
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State | AZ
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Zip | 85206-1634
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Country | US
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Telephone | 602-888-0910
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 13860
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License Number State | AZ
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