Montgomery, Monique M

Montgomery, Monique M is an individual health care provider with primary practice located at 7825 Ballantyne Commons Pkwy Suite 110, Charlotte NC 28277-3174. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Montgomery, Monique M can be contacted via phone (704) 446-0271.

Contact Information

Primary practice address
7825 Ballantyne Commons Pkwy Suite 110 Charlotte NC 28277-3174
Phone: (704) 446-0271
Fax: (704) 348-4057
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C009655 North Carolina
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCDP00473 Rhode Island
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW01506 Rhode Island

Profile Details

NPI number 1770899742
LBN Legal business name Montgomery, Monique M
Credentials LCSW, LCDP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2010
Last updated Nov 15th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770899742 NPPES
South Carolina MEDICAID SW1274
South Carolina MEDICAID 1770899742

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