1902446529 NPI number — DR. JOSEPH MONTANO JR. LCSW, PHD

Table of content: DR. JOSEPH MONTANO JR. LCSW, PHD (NPI 1902446529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902446529 NPI number — DR. JOSEPH MONTANO JR. LCSW, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTANO
Provider First Name:
JOSEPH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
LCSW, PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MONTANO
Provider Other First Name:
J.
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
JR.
Provider Other Credential Text:
LCSW, PHD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1902446529
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
182 N PALAFOX ST
Provider Second Line Business Mailing Address:
STE 104
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32502-4839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-725-5563
Provider Business Mailing Address Fax Number:
850-331-6656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
182 N PALAFOX ST
Provider Second Line Business Practice Location Address:
STE 104
Provider Business Practice Location Address City Name:
PENSACOLA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32502-4839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-725-5563
Provider Business Practice Location Address Fax Number:
850-331-6656
Provider Enumeration Date:
01/11/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW4641 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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