Provider Demographics
NPI:1427578798
Name:MONTANARO, AMY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MONTANARO
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 1:5874B MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5938
Mailing Address - Country:US
Mailing Address - Phone:443-813-3881
Mailing Address - Fax:
Practice Address - Street 1:10 WINTERS LN
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4454
Practice Address - Country:US
Practice Address - Phone:443-813-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD190071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical