Provider Demographics
NPI:1447820329
Name:MONGAK, DANIEL FRANCIS (LMFT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:FRANCIS
Last Name:MONGAK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAIN ST STE 314
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3905
Mailing Address - Country:US
Mailing Address - Phone:800-605-0612
Mailing Address - Fax:800-605-0612
Practice Address - Street 1:1 MAIN ST STE 314
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3905
Practice Address - Country:US
Practice Address - Phone:800-605-0612
Practice Address - Fax:800-605-0612
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00197700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist