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General NPI Number Information
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NPI Number | 1821729054
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Entity Type | Organization
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Legal Business Name | MONARCA BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 165 N 4TH ST
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City | LAKE MARY
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State | FL
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Zip | 32746-2954
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Country | US
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Telephone | 407-494-1342
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Fax |
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Provider Business Mailing Address
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Address Line | 165 N 4TH ST
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City | LAKE MARY
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State | FL
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Zip | 32746-2954
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Country | US
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Telephone | 407-494-1342
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | JESICA AZNAR
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Credential | LMHC
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Telephone | 407-494-1342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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