MEDICARE: BENJAMIN MAGALINDAN MONTANO MS, LPC

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	101YM0800X	Mental Health Counselor	0701012677	VA

General Provider Information

NPI Number	:	1245912054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN MAGALINDAN MONTANO MS, LPC

Provider Business Mailing Address
First Line	:	3303 JOHN TREE HILL RD
Second Line	:
City	:	POWHATAN
State	:	VA
Zip	:	23139-4521
Country	:	US
Telephone Number	:	434-414-4130
Fax Number	:

Provider Business Practice Location Address
First Line	:	1874 ANDERSON HWY BLDG C
Second Line	:
City	:	CUMBERLAND
State	:	VA
Zip	:	23040-2525
Country	:	US
Telephone Number	:	434-414-4130
Fax Number	:

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

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	08/01/2023

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