Healthcare Provider Details

I. General information

NPI: 1174311526
Provider Name (Legal Business Name): MONETTE MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 W PORTLAND ST
PHOENIX AZ
85003-1466
US

IV. Provider business mailing address

141 W PORTLAND ST UNIT 209B
PHOENIX AZ
85003-1467
US

V. Phone/Fax

Practice location:
  • Phone: 602-341-7822
  • Fax:
Mailing address:
  • Phone: 602-341-7822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: KEVANTE MONETTE
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential:
Phone: 602-877-4644