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Individual
STACIA MONTAGUE
Active
Individual
STACIA MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, BSW,LMSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1874
CT
1041C0700X
Clinical Social Worker
Primary
15579
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008060347
—
CT
01
—
060669107
UBH CONNECTICARE WELLMORE GRP/FACILITY
CT
01
—
13671439
CAQH
CT
01
—
D3392029 WATERBURY
BEACON HEALTH STRATEGIES
CT
01
—
NOT ELIGIBLE
MHN TRICARE
CT
01
—
PENDING
CIGNA BEHAVIORAL HEALTH
CT
Enumeration date
02/04/2013
Last updated
07/28/2025
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