Provider Demographics
NPI:1144764838
Name:MYERS-GALLOWAY, MONTINA (LCMHC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MONTINA
Middle Name:
Last Name:MYERS-GALLOWAY
Suffix:
Gender:F
Credentials:LCMHC, NCC
Other - Prefix:MRS
Other - First Name:MONTINA
Other - Middle Name:
Other - Last Name:MYERS-GALLOWAY, M.ED., LPCA, NCC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCA, NCC
Mailing Address - Street 1:421 S SHARON AMITY RD STE C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2879
Mailing Address - Country:US
Mailing Address - Phone:704-750-1889
Mailing Address - Fax:704-519-2683
Practice Address - Street 1:421 S SHARON AMITY RD STE C
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2879
Practice Address - Country:US
Practice Address - Phone:704-750-1889
Practice Address - Fax:704-519-2683
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health