Healthcare Provider Details

I. General information

NPI: 1932010022
Provider Name (Legal Business Name): DONIELLE MONTGOMERY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3918 ALMEDA GENOA RD APT 4307
HOUSTON TX
77047-0011
US

IV. Provider business mailing address

3918 ALMEDA GENOA RD APT 4307
HOUSTON TX
77047-0011
US

V. Phone/Fax

Practice location:
  • Phone: 409-926-1887
  • Fax:
Mailing address:
  • Phone: 409-926-1887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number117697
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number14597
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number117697
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: