MEDICARE: TAYLOR B MONTEY

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	LPC.0017394	CO

General Provider Information

NPI Number	:	1447930102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR B MONTEY

Provider Business Mailing Address
First Line	:	2007 HUNTER CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1216
Country	:	US
Telephone Number	:	720-560-3783
Fax Number	:

Provider Business Practice Location Address
First Line	:	1136 E STUART ST STE 4204
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1193
Country	:	US
Telephone Number	:	720-560-3783
Fax Number	:

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

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	07/18/2023

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