Provider Demographics
NPI:1114039294
Name:MONTSERAT, ELIZABETH WERTZ (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:WERTZ
Last Name:MONTSERAT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61933 BROKENTOP DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1085
Mailing Address - Country:US
Mailing Address - Phone:541-788-5280
Mailing Address - Fax:541-382-7233
Practice Address - Street 1:131 NW HAWTHORNE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2929
Practice Address - Country:US
Practice Address - Phone:541-788-5280
Practice Address - Fax:541-382-7233
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL33911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical