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General NPI Number Information
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NPI Number | 1407374069
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Entity Type | Organization
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Legal Business Name | MONTGOMERY COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9200 MONTGOMERY RD STE 23B
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City | MONTGOMERY
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State | OH
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Zip | 45242-7794
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Country | US
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Telephone | 513-659-0159
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Fax |
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Provider Business Mailing Address
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Address Line | 9200 MONTGOMERY RD STE 23B
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City | MONTGOMERY
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State | OH
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Zip | 45242-7794
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Country | US
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Telephone | 513-659-0159
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | AMY HUST
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Credential |
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Telephone | 513-256-3155
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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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