Healthcare Provider Details

I. General information

NPI: 1710730593
Provider Name (Legal Business Name): MONARCH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 LIGHTHOUSE DR
DOTHAN AL
36305-7302
US

IV. Provider business mailing address

208 LIGHTHOUSE DR
DOTHAN AL
36305-7302
US

V. Phone/Fax

Practice location:
  • Phone: 334-714-3509
  • Fax:
Mailing address:
  • Phone: 334-714-3509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHIRAH CHALKER
Title or Position: DIRECTOR
Credential: LICSW
Phone: 334-714-3509