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General NPI Number Information
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NPI Number | 1821162009
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Entity Type | Individual
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Provider Name | DENISE MONTGOMERY LICSW, LCSW-C, LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 4329 NORTHVIEW DR
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City | BOWIE
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State | MD
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Zip | 20716-2601
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Country | US
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Telephone | 202-423-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 2942 CHARREDWOOD DR
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City | DISTRICT HEIGHTS
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State | MD
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Zip | 20747-2791
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Country | US
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Telephone | 202-423-0040
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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 | LC50078080
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License Number State | DC
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