Provider Demographics
NPI:1740687516
Name:MONROE MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:MONROE MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROVIDER AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-548-4236
Mailing Address - Street 1:2750 ELK PARK RD
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CO
Mailing Address - Zip Code:80118-6613
Mailing Address - Country:US
Mailing Address - Phone:303-548-4236
Mailing Address - Fax:
Practice Address - Street 1:1820 W COLORADO AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3837
Practice Address - Country:US
Practice Address - Phone:303-548-4236
Practice Address - Fax:888-505-5816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-22
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003556251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health