Provider Demographics
NPI:1134942618
Name:MONTANEZ, AMY LYNN (RCSWI)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:FRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 SE CENTRAL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-5914
Mailing Address - Country:US
Mailing Address - Phone:772-497-5985
Mailing Address - Fax:
Practice Address - Street 1:10 SE CENTRAL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5914
Practice Address - Country:US
Practice Address - Phone:772-497-5985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW183291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical