Individual
MR. KEVIN J MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC, LSAC, LSW
Contact information
Practice address
100 POLK COUNTY PLZ, STE 50, BALSAM LAKE, WI 54810-9071
(715) 485-8862
(715) 485-8450
Mailing address
100 POLK COUNTY PLZ, STE 50, BALSAM LAKE, WI 54810-9071
(715) 485-8862
(715) 485-8450
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15908-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
8078-120
WI
101YP2500X
Professional Counselor
Primary
6332-125
WI
Other
Enumeration date
02/23/2012
Last updated
05/10/2017
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