Provider Demographics
NPI:1861460388
Name:MONTGOMERY, ROBERT E (LPCC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:MONTGOMERY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 BELL ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1720
Mailing Address - Country:US
Mailing Address - Phone:740-454-9766
Mailing Address - Fax:740-588-6452
Practice Address - Street 1:2845 BELL ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1720
Practice Address - Country:US
Practice Address - Phone:740-454-9766
Practice Address - Fax:740-588-6452
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE514101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000218885OtherANTHEM PIN
OH142267OtherCOMPPSYCH BH PIN
OH2032247OtherCIGNA PIN
OH3730OtherFEI BH PIN
OH6207975OtherUNITED BH PIN
OH7636250OtherAETNA PIN
OH0180406Medicaid
OH110886000OtherMAGELLAN PIN
OH212250OtherTRICARE/MHN PIN
OHY147346OtherTHE HEALTH PLAN PIN
OH6207975OtherUNITED BH PIN