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General NPI Number Information
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NPI Number | 1194232652
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Entity Type | Individual
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Provider Name | KC MONTOYA
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Gender | Male
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 400 E STATE ST
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City | ATHENS
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State | OH
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Zip | 45701-1856
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Country | US
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Telephone | 740-326-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 815 N GAY ST
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City | MOUNT VERNON
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State | OH
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Zip | 43050-1751
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Country | US
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Telephone | 740-504-6846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2102616-SUPV
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License Number State | OH
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