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Organization
MONROE OUTPATIENT TELEHEALTH SERVICES LLC
Active
Organization
MONROE OUTPATIENT TELEHEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH THOMPSON (CHIEF LEGAL & DEVELOPMENT OFFICER)
(949) 432-4622
Entity
Organization
Contact information
Practice address
19200 VON KARMAN AVE STE 500, IRVINE, CA 92612-8513
(714) 202-5166
Mailing address
L-4127, COLUMBUS, OH 43260-4127
(714) 202-5166
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
NULL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
12/04/2020
Last updated
09/15/2025
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