| Monarch Trauma Counseling Center | |
|
1630 5th Ave Suite 429 Moline IL 61265-7914 | |
| (309) 764-4733 | |
| (309) 764-2424 |
| Full Name | Monarch Trauma Counseling Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1630 5th Ave, Moline, Illinois |
| Authorized Official Name and Position | Sally Melissas Miskinis (CO-OWNER) |
| Authorized Official Contact | 3097644733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Monarch Trauma Counseling Center 1630 5th Ave Suite 429 Moline IL 61265 Ph: (309) 764-4733 | Monarch Trauma Counseling Center 1630 5th Ave Suite 429 Moline IL 61265-7914 Ph: (309) 764-4733 |
| NPI Number | 1710239793 |
|---|---|
| Provider Enumeration Date | 10/15/2012 |
| Last Update Date | 10/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710239793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180003695 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149014325 (Illinois) | Primary |
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