Provider Demographics
NPI:1417268616
Name:MONARCH THERAPY LLC
Entity Type:Organization
Organization Name:MONARCH THERAPY LLC
Other - Org Name:MONARCH WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, RPT-S, CCTP
Authorized Official - Phone:239-231-3208
Mailing Address - Street 1:2335 TAMIAMI TRL N STE 406
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4459
Mailing Address - Country:US
Mailing Address - Phone:239-231-3208
Mailing Address - Fax:
Practice Address - Street 1:2335 TAMIAMI TRL N STE 406
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4459
Practice Address - Country:US
Practice Address - Phone:239-231-3208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW86001041C0700X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty