NPIMap

Monica Jean Goodreau, OT, CHT

Individual provider Active NPI Occupational Therapist · Iron Mountain, MI

NPI 1780172742 · NPPES record last updated Apr 25, 2018

Key facts

NPI
1780172742
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201004379 (MI)
Practice address
1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone
(906) 776-5548
Fax
(906) 776-5478
NPI assigned
Apr 25, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5201004379MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dickinson County Healthcare System Occupational Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201004379 MI Yes

Addresses

Primary practice location

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637

Mailing address

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 776-5548

Other identifiers

IdentifierTypeStateIssuer
34-26OtherWIDEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES OT

Other names

  • Miss Monica Jean Masty Former name

Other providers in Iron Mountain, MI

All providers in Iron Mountain, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.