Provider Demographics
NPI:1205100955
Name:MONTELEONE, DEAN PAUL (LPC)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:PAUL
Last Name:MONTELEONE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 UPPER HEMBREE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1142
Mailing Address - Country:US
Mailing Address - Phone:678-543-5711
Mailing Address - Fax:678-543-5719
Practice Address - Street 1:1150 UPPER HEMBREE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1142
Practice Address - Country:US
Practice Address - Phone:678-543-5711
Practice Address - Fax:678-543-5719
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003742101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA45-4639712OtherEMPLOYER IDENTIFICATION NUMBER