Provider Demographics
NPI:1386659159
Name:MONTERO, DENISE MARY (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MARY
Last Name:MONTERO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10415 EDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1125
Mailing Address - Country:US
Mailing Address - Phone:301-445-4734
Mailing Address - Fax:301-445-4739
Practice Address - Street 1:10415 EDGEFIELD DR
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1125
Practice Address - Country:US
Practice Address - Phone:301-445-4734
Practice Address - Fax:301-445-4739
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD33971041C0700X
DCLC3000621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
698296Medicare ID - Type Unspecified