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NPI Code Detail

MEDICARE: MONIQUE CANDACE MATIC LPC, LCPC, ATR-BC

MEDICARE: MONIQUE CANDACE MATIC LPC, LCPC, ATR-BC
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
1101YM0800XMental Health Counselor180008741IL
2101YP2500XProfessional Counselor5177-125WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801223011
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE CANDACE MATIC LPC, LCPC, ATR-BC
Provider Business Mailing Address
First Line : 17700 W CAPITOL DR
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-2006
Country : US
Telephone Number : 262-453-5800
Fax Number :
Provider Business Practice Location Address
First Line : 17700 W CAPITOL DR
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-2006
Country : US
Telephone Number : 262-453-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2013
Last Update Date : 12/31/2025

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Directions to “ MONIQUE CANDACE MATIC LPC, LCPC, ATR-BC” Practice Location

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