MEDICARE: DR. ROSALIND MAXINE MONAHAN PHD., LCSW

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	LCS16205	CA

General Provider Information

NPI Number	:	1669555124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSALIND MAXINE MONAHAN PHD., LCSW

Provider Business Mailing Address
First Line	:	77564 COUNTRY CLUB DR # B
Second Line	:	405-B
City	:	PALM DESERT
State	:	CA
Zip	:	92211-0484
Country	:	US
Telephone Number	:	760-776-2525
Fax Number	:	760-772-7730

Provider Business Practice Location Address
First Line	:	77564 COUNTRY CLUB DR # B
Second Line	:	STE. 405-B
City	:	PALM DESERT
State	:	CA
Zip	:	92211-0484
Country	:	US
Telephone Number	:	760-776-2525
Fax Number	:

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	12/26/2012

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