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General NPI Number Information
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NPI Number | 1164165023
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Entity Type | Individual
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Provider Name | MONICA CHAN SONNER-PERRY LADC
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Gender | Female
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Dates
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Enumeration Date | 04/19/2022
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 400 WESTERN AVE
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-1704
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Country | US
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Telephone | 207-405-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 128 WESTERN AVE
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City | WATERVILLE
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State | ME
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Zip | 04901-5215
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Country | US
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Telephone | 614-914-0814
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAC7786
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LC7901
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License Number State | ME
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