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General NPI Number Information
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NPI Number | 1558027433
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Entity Type | Organization
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Legal Business Name | MONARCH COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 401 W ONTARIO ST STE 150
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City | CHICAGO
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State | IL
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Zip | 60654-6750
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Country | US
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Telephone | 833-444-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 7149 N OZARK AVE
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City | CHICAGO
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State | IL
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Zip | 60631-1067
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Country | US
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Telephone | 847-401-1440
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANTHONY CAMPOBASSO
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Credential | LCSW, CADC, CIP
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Telephone | 833-444-2883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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