Organization
MONTGOMERY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS MONTGOMERY (LCSW)
(208) 463-0212
Entity
Organization
Contact information
Practice address
323 12TH AVE RD, NAMPA, ID 83686-5014
(208) 463-0212
(208) 461-5452
Mailing address
323 12TH AVE RD, NAMPA, ID 83686-5014
(208) 463-0212
(208) 461-5452
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW 712
ID
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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