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NPI Code Detail

MEDICARE: YAMID OMAR MONTALVO LPC

MEDICARE:   YAMID OMAR MONTALVO  LPC
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
1101YP2500XProfessional Counselor84750TX

General Provider Information

NPI Number : 1861128878
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAMID OMAR MONTALVO LPC
Provider Business Mailing Address
First Line : 2028 E BEN WHITE BLVD STE 240A
Second Line :
City : AUSTIN
State : TX
Zip : 78741-6966
Country : US
Telephone Number : 760-858-3071
Fax Number :
Provider Business Practice Location Address
First Line : 2501 W WILLIAM CANNON DR BLDG 4
Second Line :
City : AUSTIN
State : TX
Zip : 78745-5281
Country : US
Telephone Number : 512-804-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2022
Last Update Date : 04/09/2026

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Directions to “ YAMID OMAR MONTALVO LPC” Practice Location

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