Healthcare Provider Details

I. General information

NPI: 1225907835
Provider Name (Legal Business Name): RIDGELINE CLINICAL COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 N GILBERT RD STE A213
GILBERT AZ
85234-4771
US

IV. Provider business mailing address

459 N GILBERT RD STE A213
GILBERT AZ
85234-4771
US

V. Phone/Fax

Practice location:
  • Phone: 480-810-4997
  • Fax: 480-214-3178
Mailing address:
  • Phone: 480-810-4997
  • Fax: 480-214-3178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN ERIK MONTANO
Title or Position: OWNER
Credential: LAC
Phone: 480-810-4997