Provider Demographics
NPI:1144823774
Name:MONTEMAYOR, SOPHIA MARIE (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:SOPHIA
Middle Name:MARIE
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 SQUAW PASS CT
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4325
Mailing Address - Country:US
Mailing Address - Phone:361-688-3182
Mailing Address - Fax:
Practice Address - Street 1:3833 S STAPLES ST STE 203
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5201
Practice Address - Country:US
Practice Address - Phone:361-852-9665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional