Provider Demographics
NPI:1487667721
Name:MONTALVO, BARBARA J (MSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 FITCHBURG RD
Mailing Address - Street 2:
Mailing Address - City:ASHBURNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01430-1414
Mailing Address - Country:US
Mailing Address - Phone:978-878-8100
Mailing Address - Fax:978-665-5808
Practice Address - Street 1:275 NICHOLS RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-1931
Practice Address - Country:US
Practice Address - Phone:978-878-8100
Practice Address - Fax:978-665-5808
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113647103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1319833Medicaid
MA221868OtherUGS
MA1320815Medicaid
MA221845OtherUGS
MAM17925OtherBC MA
MA221868OtherUGS
MAM21400Medicare Oscar/Certification
MIP24080Medicare PIN