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General NPI Number Information
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NPI Number | 1346034477
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Entity Type | Organization
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Legal Business Name | MONTGOMERY CHRISTIAN COUNSELING, LLC
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 1436 S LEGEND HILLS DR STE 335
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City | CLEARFIELD
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State | UT
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Zip | 84015-2187
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Country | US
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Telephone | 801-444-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 611 CRESTWOOD RD
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City | KAYSVILLE
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State | UT
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Zip | 84037-1709
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Country | US
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Telephone | 801-844-1003
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JODI RENAE MONTGOMERY
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Credential | CMHC, LPC
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Telephone | 801-866-8984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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