MEDICARE: MS. KITTY JOAN ANN MONTIE LCSW-C

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	1041C0700X	Clinical Social Worker	2773	MD
2	1041C0700X	Clinical Social Worker	0904003076	VA

General Provider Information

NPI Number	:	1184747180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KITTY JOAN ANN MONTIE LCSW-C

Provider Business Mailing Address
First Line	:	8609 2ND AVE
Second Line	:	SUITE 307B
City	:	SILVER SPRING
State	:	MD
Zip	:	20910
Country	:	US
Telephone Number	:	301-589-8505
Fax Number	:

Provider Business Practice Location Address
First Line	:	8609 2ND AVE
Second Line	:	SUITE 307B
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3360
Country	:	US
Telephone Number	:	301-589-8505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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