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NPI Code Detail

MEDICARE: MICHAEL MONTOYA LSAA

MEDICARE: MICHAEL MONTOYA LSAA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCTB-2026-0033NM

General Provider Information

NPI Number : 1841159522
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MONTOYA LSAA
Provider Business Mailing Address
First Line : 12100 MENAUL BLVD NE APT B
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-2423
Country : US
Telephone Number : 612-999-8135
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SAN PEDRO DR NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-6734
Country : US
Telephone Number : 505-404-0717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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