MEDICARE: MRS. LAURYN HOPE MONTGOMERY M.A.

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	101Y00000X	Counselor
2	101Y00000X	Counselor	39003757A	IN

General Provider Information

NPI Number	:	1760930358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURYN HOPE MONTGOMERY M.A.

Provider Business Mailing Address
First Line	:	2360 WESTMERE DR
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-4702
Country	:	US
Telephone Number	:	317-853-9328
Fax Number	:

Provider Business Practice Location Address
First Line	:	1660 E MAIN ST STE 107B
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-2816
Country	:	US
Telephone Number	:	317-286-6701
Fax Number	:

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

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	05/29/2025

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