MEDICARE: MICHAEL C LAMONICA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	PC018832	PA

General Provider Information

NPI Number	:	1447138482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL C LAMONICA

Provider Business Mailing Address
First Line	:	3129 TILTON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-5816
Country	:	US
Telephone Number	:	732-513-9214
Fax Number	:

Provider Business Practice Location Address
First Line	:	3129 TILTON ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-5816
Country	:	US
Telephone Number	:	732-513-9214
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	09/19/2025

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