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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073679676 NPPES
Massachusetts Other 468743 TUFTS HEALTH PLAN ID
Massachusetts Other P08270 TUFTS HEALTH PLAN ID

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