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NPI Code Detail

MEDICARE: MS. NAOMI D MONTAGUE LCSW-R

MEDICARE: MS. NAOMI D MONTAGUE LCSW-R
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
11041C0700XClinical Social Worker047370-01NY
21041C0700XClinical Social WorkerR047370NY

General Provider Information

NPI Number : 1841388238
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NAOMI D MONTAGUE LCSW-R
Provider Business Mailing Address
First Line : 2604 ELMWOOD AVE STE 299
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-2213
Country : US
Telephone Number : 585-419-7019
Fax Number : 585-627-0792
Provider Business Practice Location Address
First Line : 6539 ANTHONY DR STE A
Second Line :
City : VICTOR
State : NY
Zip : 14564-1441
Country : US
Telephone Number : 585-398-8835
Fax Number : 585-398-7376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 03/03/2025

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