Provider Demographics
NPI:1285045948
Name:HAUCK, MONTE (ACMHC)
Entity Type:Individual
Prefix:
First Name:MONTE
Middle Name:
Last Name:HAUCK
Suffix:
Gender:M
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51275
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84605-1275
Mailing Address - Country:US
Mailing Address - Phone:435-462-9336
Mailing Address - Fax:435-462-5336
Practice Address - Street 1:224 N OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-6601
Practice Address - Country:US
Practice Address - Phone:801-222-0603
Practice Address - Fax:801-222-0218
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6521025-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health