Provider Demographics
NPI:1114666161
Name:MONARCH EDUCATIONAL AND PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:MONARCH EDUCATIONAL AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENSIGN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:321-305-4342
Mailing Address - Street 1:590 SOLUTIONS WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:590 SOLUTIONS WAY STE 110
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3623
Practice Address - Country:US
Practice Address - Phone:321-305-4342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health