Provider Demographics
NPI:1295356533
Name:MONARCH JOURNEY COUNSELING LLC
Entity Type:Organization
Organization Name:MONARCH JOURNEY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GADDY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-450-7675
Mailing Address - Street 1:14125 JAMES MADISON HWY
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960-2819
Mailing Address - Country:US
Mailing Address - Phone:757-450-7675
Mailing Address - Fax:
Practice Address - Street 1:14125 JAMES MADISON HWY
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-2819
Practice Address - Country:US
Practice Address - Phone:757-450-7675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)