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General NPI Number Information
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NPI Number | 1477978351
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Entity Type | Individual
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Provider Name | BRENDA MONTIEL-BAHLAWAN LPC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2014
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 1122 NW 143RD AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2914
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Country | US
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Telephone | 956-289-7025
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Fax | 956-289-7257
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Provider Business Mailing Address
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Address Line | 1122 NW 143RD AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2914
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Country | US
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Telephone | 956-289-7025
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Fax | 956-289-7257
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH24902
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 69127
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License Number State | TX
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