Healthcare Provider Details

I. General information

NPI: 1750013561
Provider Name (Legal Business Name): MONESELF CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 NEW YORK ST
WEST PALM BEACH FL
33401-6602
US

IV. Provider business mailing address

734 NEW YORK ST
WEST PALM BEACH FL
33401-6602
US

V. Phone/Fax

Practice location:
  • Phone: 561-685-6934
  • Fax:
Mailing address:
  • Phone: 561-685-6934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADAM COLLING
Title or Position: CEO
Credential: LMHC, MCAP, ICADC
Phone: 561-685-6934