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NPI Code Detail

MEDICARE: MRS. REESHA FAYE JEANETTE MONTGOMERY LMFT

MEDICARE: MRS. REESHA FAYE JEANETTE MONTGOMERY LMFT
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
1106H00000XMarriage & Family TherapistMT3417FL
2101YM0800XMental Health CounselorMT3417FL

Other Identifiers

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

General Provider Information

NPI Number : 1932482296
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REESHA FAYE JEANETTE MONTGOMERY LMFT
Provider Business Mailing Address
First Line : 5707 N 22ND ST
Second Line :
City : TAMPA
State : FL
Zip : 33610-4350
Country : US
Telephone Number : 813-239-8069
Fax Number : 813-231-7324
Provider Business Practice Location Address
First Line : PO BOX 748465
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8465
Country : US
Telephone Number : 855-284-7483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 02/19/2025

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