Provider Demographics
NPI:1710663257
Name:MONARCH COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:MONARCH COUNSELING CENTER LLC
Other - Org Name:MONARCH COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-669-5411
Mailing Address - Street 1:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-0495
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:666 GODWIN AVE STE 120-5
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1449
Practice Address - Country:US
Practice Address - Phone:201-669-5411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1952034647Medicaid