Provider Demographics
NPI:1598374670
Name:MONROE, JARED (LMSW)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:MONROE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11410 W DAVIS LN
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-1101
Mailing Address - Country:US
Mailing Address - Phone:623-866-8922
Mailing Address - Fax:
Practice Address - Street 1:4253 N CRAFTSMAN CT
Practice Address - Street 2:STE 11
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-8525
Practice Address - Country:US
Practice Address - Phone:623-404-1821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-18351104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker