Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Monderrick Willis

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1982470266

Monderrick Willis is an Addiction (Substance Use Disorder) Counselor in New York, New York. Licensed in New York. Registered with an NPI since 2023.

Licensed in
NY
In the registry since
2023

Practice location Address checks out

394 Broadway Fl 4
New York, NY 10013-6023
Phone: (718) 516-6007
Fax: (212) 584-5450
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 39117 (NY)

Record details

NPI number1982470266
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 28, 2023
Last updated in NPPESNovember 28, 2023
Certification dateNovember 28, 2023

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