Montgomery, Susan L
Montgomery, Susan L is an individual health care provider with primary practice located at 923 Route 6A Unit N , Yarmouth Port MA 02675-2159. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Montgomery, Susan L can be contacted via phone (508) 362-4250.Contact Information
Primary practice address
923 Route 6A Unit N
Yarmouth Port MA 02675-2159
Phone: (508) 362-4250
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 111611 | Massachusetts |
Profile Details
| NPI number | 1073679676 |
|---|---|
| LBN Legal business name | Montgomery, Susan L |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073679676 | NPPES |
| Massachusetts | Other | 468743 | TUFTS HEALTH PLAN ID |
| Massachusetts | Other | P08270 | TUFTS HEALTH PLAN ID |
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