1821870270 NPI number — MONARCH COUNSELING CENTER, LLC

Table of content: (NPI 1821870270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821870270 NPI number — MONARCH COUNSELING CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONARCH COUNSELING CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821870270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8980 FASCINATION CT APT 415
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LORTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22079-5717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-903-1888
Provider Business Mailing Address Fax Number:
540-657-3667

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10340 DEMOCRACY LN STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22030-2518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-903-1888
Provider Business Practice Location Address Fax Number:
540-657-3667
Provider Enumeration Date:
10/19/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RUMMEL
Authorized Official First Name:
MARCELLA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
540-903-1888

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)