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General NPI Number Information
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NPI Number | 1528186715
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Entity Type | Individual
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Provider Name | MONIQUE M. CHURCHILL LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 6037 ALLEGHENY RD
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-7370
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Country | US
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Telephone | 626-241-7009
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Fax | 626-241-7009
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Provider Business Mailing Address
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Address Line | 6037 ALLEGHENY RD
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-7370
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Country | US
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Telephone | 626-241-7009
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 61300478
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 15227
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF46139
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC49805
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717002418
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License Number State | VA
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