| Doctor Name: | MRS. MICHELLE L MONFORT |
| NPI Number: | 1053721548 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LISW |
| License Number: | I.1501424 |
| Business Practice Address: | 111 W Espy St Kenton, OH - 433262117 |
| Business Phone Number: | 4196795994 |
| Business Fax Number: | 4192258878 |
| Mailing Address: | 329 N West St, 2nd Floor LIMA |
| State: | OH |
| Postal Code: | 458014332 |
| Phone Number: | 4192213072 |
| Fax Number: | 4195495670 |
| NPI Enumeration Date: | 05/06/2014 |
| NPI Last Update Date: | 05/24/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I.1501424 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |