Provider Demographics
NPI:1023833803
Name:MONT'S HAVEN & CONSULTING
Entity type:Organization
Organization Name:MONT'S HAVEN & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHANIQUA
Authorized Official - Middle Name:QUANESE
Authorized Official - Last Name:GAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-454-0552
Mailing Address - Street 1:132 HILLSIDE TER
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1514
Mailing Address - Country:US
Mailing Address - Phone:973-454-0552
Mailing Address - Fax:
Practice Address - Street 1:132 HILLSIDE TER
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1514
Practice Address - Country:US
Practice Address - Phone:973-454-0552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty