MEDICARE: JEAN-MARY MONVAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003224338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN-MARY MONVAL

Provider Business Mailing Address
First Line	:	2011 S 25TH ST STE 108
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4795
Country	:	US
Telephone Number	:	772-242-1079
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 S 25TH ST STE 108
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4795
Country	:	US
Telephone Number	:	772-242-1079
Fax Number	:	772-242-1296

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2014
Last Update Date	:	05/03/2025

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