Provider Demographics
NPI:1861557910
Name:DRAYTON, MONIKA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MONIKA
Middle Name:
Last Name:DRAYTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11012 DIXIE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2936
Mailing Address - Country:US
Mailing Address - Phone:980-224-7579
Mailing Address - Fax:980-224-7579
Practice Address - Street 1:100 BILLINGSLEY DRIVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-8880
Practice Address - Country:US
Practice Address - Phone:980-225-8936
Practice Address - Fax:980-321-5366
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0065901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007626Medicaid