Individual
MR. MARK ALYN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LISAC
Contact information
Practice address
4554 E. INVERNESS AVE., C-108, MESA, AZ 85206-4639
(480) 330-5031
(480) 926-2326
Mailing address
4554 E INVERNESS AVE # C-108, MESA, AZ 85206-4639
(480) 330-5031
(480) 926-2326
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-1677
AZ
101YM0800X
Mental Health Counselor
LPC-2087
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LISAC-1677
LIC. IND. SUB. ABUSE COUN
AZ
01
—
LPC-2087
LICENSED PROF. COUNSELOR
AZ
Enumeration date
11/01/2006
Last updated
09/11/2025
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