Provider Demographics
NPI:1497068258
Name:HOLLY MONROE CONSULTING GROUP LLC
Entity Type:Organization
Organization Name:HOLLY MONROE CONSULTING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY-LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-558-1006
Mailing Address - Street 1:18 DOG LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:STORRS MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06268-2225
Mailing Address - Country:US
Mailing Address - Phone:860-558-1006
Mailing Address - Fax:860-394-4253
Practice Address - Street 1:18 DOG LN
Practice Address - Street 2:SUITE C
Practice Address - City:STORRS MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06268-2225
Practice Address - Country:US
Practice Address - Phone:860-558-1006
Practice Address - Fax:860-394-4253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1390106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty