Provider Demographics
NPI:1174311526
Name:MONETTE MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MONETTE MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-977-0316
Mailing Address - Street 1:11575 W ROOSEVELT ST UNIT M305
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-5053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11575 W ROOSEVELT ST UNIT M305
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-5053
Practice Address - Country:US
Practice Address - Phone:480-790-3991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty