Provider Demographics
NPI:1477605806
Name:MONARCH COUNSELING SERVICES
Entity type:Organization
Organization Name:MONARCH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MADREE
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:208-964-4879
Mailing Address - Street 1:1869 E SELTICE WAY # 389
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7082
Mailing Address - Country:US
Mailing Address - Phone:208-964-4879
Mailing Address - Fax:208-765-2558
Practice Address - Street 1:1620 NORTHWEST BLVD STE 201
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2488
Practice Address - Country:US
Practice Address - Phone:208-964-4879
Practice Address - Fax:208-765-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807652000Medicaid
ID807335700Medicaid
ID807342300Medicaid