Provider Demographics
NPI:1073906798
Name:MONARCH COUNSELING SERVICE
Entity Type:Organization
Organization Name:MONARCH COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:POPOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LGSW
Authorized Official - Phone:218-372-3801
Mailing Address - Street 1:72351 PINE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55795-3120
Mailing Address - Country:US
Mailing Address - Phone:218-372-3801
Mailing Address - Fax:
Practice Address - Street 1:72351 PINE RIVER RD
Practice Address - Street 2:
Practice Address - City:WILLOW RIVER
Practice Address - State:MN
Practice Address - Zip Code:55795-3120
Practice Address - Country:US
Practice Address - Phone:218-372-3801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23790251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health