Provider Demographics
NPI:1558027433
Name:MONARCH COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:MONARCH COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOBASSO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC, CIP
Authorized Official - Phone:833-444-2883
Mailing Address - Street 1:7149 N OZARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1067
Mailing Address - Country:US
Mailing Address - Phone:847-401-1440
Mailing Address - Fax:
Practice Address - Street 1:401 W ONTARIO ST STE 150
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-6750
Practice Address - Country:US
Practice Address - Phone:833-444-2883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health