Healthcare Provider Details

I. General information

NPI: 1245085695
Provider Name (Legal Business Name): ALEAH A MONTANO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12836 LOMAS BLVD NE STE C
ALBUQUERQUE NM
87112-6200
US

IV. Provider business mailing address

918 KENT AVE NW
ALBUQUERQUE NM
87102-2914
US

V. Phone/Fax

Practice location:
  • Phone: 505-453-8984
  • Fax:
Mailing address:
  • Phone: 505-453-8984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2024-0246
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: