Healthcare Provider Details

I. General information

NPI: 1275810087
Provider Name (Legal Business Name): HENRY A MONTERO LMHC, CASAC, CTTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 11/13/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 W 80TH ST FL 4 STE 15
NEW YORK NY
10024
US

IV. Provider business mailing address

2248 BROADWAY STE 1329
NEW YORK NY
10024-5805
US

V. Phone/Fax

Practice location:
  • Phone: 315-505-2400
  • Fax: 914-505-2458
Mailing address:
  • Phone: 315-610-6675
  • Fax: 914-505-2458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number005404-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005404-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC012896
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number192617
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00516400
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-19636
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number27480
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH18912
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005022
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: