Provider Demographics
NPI:1265974323
Name:MONK, STEVENGROWER GERALD (CASE MANAGEMENT)
Entity type:Individual
Prefix:MR
First Name:STEVENGROWER
Middle Name:GERALD
Last Name:MONK
Suffix:
Gender:M
Credentials:CASE MANAGEMENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1239 NE 12TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-2209
Mailing Address - Country:US
Mailing Address - Phone:954-599-6800
Mailing Address - Fax:
Practice Address - Street 1:450 E PROSPECT RD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-1423
Practice Address - Country:US
Practice Address - Phone:954-530-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator