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NPI Code Detail

MEDICARE: SHUNTA' MONTGOMERY LPC

MEDICARE:   SHUNTA'  MONTGOMERY  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
1101YM0800XMental Health Counselor85059TX
2101YP2500XProfessional Counselor85059TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
185059OTHERTXTEXAS STATE LICENSE

General Provider Information

NPI Number : 1962158212
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHUNTA' MONTGOMERY LPC
Provider Business Mailing Address
First Line : PO BOX 1098
Second Line :
City : POINTBLANK
State : TX
Zip : 77364-1098
Country : US
Telephone Number : 832-233-3086
Fax Number : 832-415-3050
Provider Business Practice Location Address
First Line : 1801 KINGWOOD DR STE 200
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-3059
Country : US
Telephone Number : 832-233-3086
Fax Number : 832-415-3050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2022
Last Update Date : 03/29/2023

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Directions to “ SHUNTA' MONTGOMERY LPC” Practice Location

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