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NPI Code Detail

MEDICARE: ANNA MONTGOMERY LSW

MEDICARE: ANNA MONTGOMERY LSW
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
1104100000XSocial Worker104929NY
2104100000XSocial WorkerS.2410413OH

General Provider Information

NPI Number : 1366927048
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA MONTGOMERY LSW
Provider Business Mailing Address
First Line : 1020 SYMMES RD
Second Line :
City : FAIRFIELD
State : OH
Zip : 45014-1844
Country : US
Telephone Number : 513-645-4578
Fax Number : 513-883-1546
Provider Business Practice Location Address
First Line : 2052 PRINCETON RD
Second Line :
City : FAIRFIELD TOWNSHIP
State : OH
Zip : 45011-4746
Country : US
Telephone Number : 513-863-6383
Fax Number : 513-863-9882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2018
Last Update Date : 01/30/2026

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