Individual
MR. ALEXANDER LEONARD MONTGOMERY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
251 CLOVER RD, LEESVILLE, SC 29070-7739
(803) 807-2336
Mailing address
251 CLOVER RD, LEESVILLE, SC 29070-7739
(803) 807-2336
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5689
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
465708663
TRICARE
SC
01
—
5689
SC LICENSE
SC
05
—
PC1386
—
SC
Enumeration date
05/28/2014
Last updated
09/07/2014
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