Provider Demographics
NPI:1073212403
Name:MONFORD DENT CONSULTING & PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:MONFORD DENT CONSULTING & PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TYFFANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MONFORD DENT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:216-644-8620
Mailing Address - Street 1:PO BOX 25361
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-0361
Mailing Address - Country:US
Mailing Address - Phone:166-448-6202
Mailing Address - Fax:
Practice Address - Street 1:6415 VALLEY RANCH DR
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-4776
Practice Address - Country:US
Practice Address - Phone:216-644-8620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty