Healthcare Provider Details

I. General information

NPI: 1497266787
Provider Name (Legal Business Name): ANGELA MONTEZ LCPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date: 07/19/2018
Reactivation Date: 07/31/2018

III. Provider practice location address

123 S 27TH ST
BILLINGS MT
59101-4227
US

IV. Provider business mailing address

123 S 27TH ST
BILLINGS MT
59101-4227
US

V. Phone/Fax

Practice location:
  • Phone: 406-247-3350
  • Fax: 406-247-3389
Mailing address:
  • Phone: 406-247-3350
  • Fax: 406-247-3389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBBH-LAC-LIC-25485
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-LCPC-LIC-30837
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: