Healthcare Provider Details

I. General information

NPI: 1215559257
Provider Name (Legal Business Name): JULITA MONTGOMERY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 N VILLERE ST
NEW ORLEANS LA
70116-2939
US

IV. Provider business mailing address

933 N VILLERE ST
NEW ORLEANS LA
70116-2939
US

V. Phone/Fax

Practice location:
  • Phone: 504-215-2923
  • Fax:
Mailing address:
  • Phone: 504-215-2923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14133
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number14133
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: