Provider Demographics
NPI:1306210489
Name:MONARCH PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:MONARCH PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCO-OILAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-261-0699
Mailing Address - Street 1:2499 GLADES RD STE 107
Mailing Address - Street 2:SUITE 165
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7260
Mailing Address - Country:US
Mailing Address - Phone:561-513-4372
Mailing Address - Fax:
Practice Address - Street 1:2499 GLADES RD STE 107
Practice Address - Street 2:SUITE 165
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7260
Practice Address - Country:US
Practice Address - Phone:561-513-4372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9364103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty