Provider Demographics
NPI:1528200797
Name:MONTANA, ROBERTO (LPC)
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:
Last Name:MONTANA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:
Other - Last Name:MONTANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:265 RISEN STAR LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-7873
Mailing Address - Country:US
Mailing Address - Phone:404-502-7957
Mailing Address - Fax:770-751-0453
Practice Address - Street 1:2855 BRIARCLIFF RD.
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2501
Practice Address - Country:US
Practice Address - Phone:404-636-4394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 000692101YA0400X, 101YM0800X
GALPC000692101YP2500X, 101YS0200X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist