Provider Demographics
NPI:1992383400
Name:MONREAL FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:MONREAL FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MONREAL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:928-235-6097
Mailing Address - Street 1:PO BOX 25757
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86312-5757
Mailing Address - Country:US
Mailing Address - Phone:928-713-1879
Mailing Address - Fax:
Practice Address - Street 1:1101 N OLD CHISHOLM TRL STE A
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-5833
Practice Address - Country:US
Practice Address - Phone:928-235-6097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ410033Medicaid