Individual
JOSEPH PAUL MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
24715 LITTLE MACK AVE STE 200, SAINT CLAIR SHORES, MI 48080-3207
(586) 777-9000
(586) 777-0823
Mailing address
24715 LITTLE MACK AVE STE 200, SAINT CLAIR SHORES, MI 48080-3207
(586) 777-9000
(586) 777-0823
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401011520
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704318966
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75091042
BLUE CROSS
MI
Enumeration date
12/22/2009
Last updated
05/07/2025
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