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Individual

MR. BRUCE CARR LAMONTAGNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSW

Contact information

Practice address
3000 LENHART RD, SPRINGFIELD, IL 62711-9203
(217) 698-7150
(217) 698-7085
Mailing address
3000 LENHART RD, SPRINGFIELD, IL 62711-9203
(217) 698-7150
(217) 698-7085

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
150002069
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
150002069
IL
101YM0800X
Mental Health Counselor
150002069
IL
101YP2500X
Professional Counselor
150002069
IL

Other

Enumeration date
06/19/2012
Last updated
06/19/2012
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