MEDICARE: SPERANZA COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1063163301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPERANZA COUNSELING

Provider Business Mailing Address
First Line	:	6283 E LAUGHERY CREEK RD
Second Line	:
City	:	AURORA
State	:	IN
Zip	:	47001-9768
Country	:	US
Telephone Number	:	859-363-6213
Fax Number	:

Provider Business Practice Location Address
First Line	:	6283 E LAUGHERY CREEK RD
Second Line	:
City	:	AURORA
State	:	IN
Zip	:	47001-9768
Country	:	US
Telephone Number	:	859-363-6213
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEAGAN MONTGOMERY
Credential	:	LPCC
Telephone Number	:	812-701-2701

Provider Enumeration Date	:	01/18/2022
Last Update Date	:	02/02/2022

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Directions to “SPERANZA COUNSELING ” Practice Location

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