Provider Demographics
NPI:1821162009
Name:MONTGOMERY, DENISE (LICSW, LCSW-C, LMFT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:LICSW, LCSW-C, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2942 CHARREDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2791
Mailing Address - Country:US
Mailing Address - Phone:202-423-0040
Mailing Address - Fax:
Practice Address - Street 1:4329 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2601
Practice Address - Country:US
Practice Address - Phone:202-423-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500780801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical