Montgomery, Robert W

Montgomery, Robert W is an individual health care provider with primary practice located at 107 Weatherstone Dr Suite 530, Woodstock GA 30188. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Montgomery, Robert W can be contacted via phone (770) 591-9552.

Contact Information

Primary practice address
107 Weatherstone Dr Suite 530 Woodstock GA 30188
Phone: (770) 591-9552
Fax: (800) 218-8249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-03-1376
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY001980 Georgia

Profile Details

NPI number 1437268125
LBN Legal business name Montgomery, Robert W
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Nov 18th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437268125 NPPES
Georgia MEDICAID 000637777F
Georgia MEDICAID 000637777E
Georgia MEDICAID 003216493A

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