PHYLLIS MONTGOMERY LCSW NPI 1316106107

NPI Information

NPI: 1316106107
Provider Name: PHYLLIS MONTGOMERY, LCSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
323 12TH AVE RD
NAMPA, ID
ZIP 83686
Phone: (208) 463-0212
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Phyllis Montgomery, LCSW is a mental health counselor in Nampa, ID. Phyllis Montgomery, LCSW NPI is 1316106107. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

323 12TH AVE RD
NAMPA, ID
ZIP 83686-014
Phone: (208) 463-0212
Fax: (208) 461-5452

The enumeration date for this NPI number is 6/5/2008 and was last updated on 6/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	LCSW 712	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	002743500	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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