Healthcare Provider Details

I. General information

NPI: 1982541710
Provider Name (Legal Business Name): GREEN MONARCH HEALTH PRACTICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 1ST AVE NW STE 201 UNIT 210
HICKORY NC
28601-6169
US

IV. Provider business mailing address

4431 JIM BEARD RD
MAIDEN NC
28650-8586
US

V. Phone/Fax

Practice location:
  • Phone: 980-506-7585
  • Fax: 949-844-2015
Mailing address:
  • Phone: 828-748-2875
  • Fax: 949-844-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KENNETH ALLAN LEVESQUE
Title or Position: PROVIDER
Credential: PMHNP-BC
Phone: 980-506-7585