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Individual
MONIQUE M MONTGOMERY
Active
Individual
MONIQUE M MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCDP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDP00473
RI
1041C0700X
Clinical Social Worker
Primary
C009655
NC
1041C0700X
Clinical Social Worker
CSW01506
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770899742
—
NC
05
—
SW1274
—
SC
Enumeration date
08/27/2010
Last updated
11/15/2016
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