Healthcare Provider Details

I. General information

NPI: 1871017343
Provider Name (Legal Business Name): M CHRISTINA MONTOYA LCSW, CJSOT,BSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RIATA TRL SE
RIO RANCHO NM
87124-5940
US

IV. Provider business mailing address

101 RIATA TRL SE
RIO RANCHO NM
87124-5940
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-9966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-0627
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberX-09839
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: