Individual
PHILIP C MONGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1909 COMMERCE AVE, CULLMAN, AL 35055-6151
(256) 734-4688
Mailing address
1508 15TH AVE SW, DECATUR, AL 35601-5404
(218) 330-1263
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330000025
—
AL
01
—
515-93732
BLUE CROSS BLUE SHIELD
AL
Enumeration date
09/04/2008
Last updated
02/23/2011
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