MEDICARE: SHANNON CALDWELL MONTEZ LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	12358-M	NV

General Provider Information

NPI Number	:	1699665596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON CALDWELL MONTEZ LMSW

Provider Business Mailing Address
First Line	:	2930 OUTLOOK DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-3954
Country	:	US
Telephone Number	:	408-887-6917
Fax Number	:

Provider Business Practice Location Address
First Line	:	2930 OUTLOOK DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-3954
Country	:	US
Telephone Number	:	408-887-6917
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2025
Last Update Date	:	07/03/2025

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