MEDICARE: JESSICA R MONTOYA LPCC

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	CCMH0216901	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558720474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA R MONTOYA LPCC

Provider Business Mailing Address
First Line	:	6105 JAMERS DR NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-3217
Country	:	US
Telephone Number	:	505-382-3464
Fax Number	:

Provider Business Practice Location Address
First Line	:	6330 RIVERSIDE PLAZA LN NW STE 260
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2160
Country	:	US
Telephone Number	:	505-226-2839
Fax Number	:	505-295-2559

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

Provider Enumeration Date	:	02/20/2016
Last Update Date	:	08/02/2021

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Directions to “ JESSICA R MONTOYA LPCC” Practice Location

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