Individual
SUSAN MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCP, LCAC, LMLP
Contact information
Practice address
645 E IRON AVE STE C, SALINA, KS 67401-2697
(800) 423-1342
(785) 628-3113
Mailing address
509 E ELM ST, SALINA, KS 67401-2353
(800) 423-1342
(785) 628-3113
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
050
KS
103T00000X
Psychologist
2811
KS
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
011
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200435200B
—
KS
Enumeration date
07/19/2007
Last updated
09/14/2020
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