Provider Demographics
NPI:1710465877
Name:MONTALBANO, JENNA ELIZABETH (LACMH, CADC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:ELIZABETH
Last Name:MONTALBANO
Suffix:
Gender:F
Credentials:LACMH, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MILLTOWN RD STE 13
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4084
Mailing Address - Country:US
Mailing Address - Phone:302-827-7280
Mailing Address - Fax:302-853-4100
Practice Address - Street 1:1601 MILLTOWN RD STE 13
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4084
Practice Address - Country:US
Practice Address - Phone:302-827-7280
Practice Address - Fax:302-853-4100
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE805625101YA0400X
NJ37AC00682200101YM0800X
DEAC-0010361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE$$$$$$$$$OtherPRIVATE PRACTICE