Healthcare Provider Details

I. General information

NPI: 1093625410
Provider Name (Legal Business Name): SHATOYA MONTREZ PERSON LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 PLEASANT KNOLL LN
MONROE NC
28112-6181
US

IV. Provider business mailing address

2035 PLEASANT KNOLL LN
MONROE NC
28112-6181
US

V. Phone/Fax

Practice location:
  • Phone: 252-676-9430
  • Fax:
Mailing address:
  • Phone: 252-676-9430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: