Provider Demographics
NPI:1265716286
Name:MONTGOMERY, JANET REED (LLPC)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:REED
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 HAWTHORNE CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3016
Mailing Address - Country:US
Mailing Address - Phone:248-594-6274
Mailing Address - Fax:
Practice Address - Street 1:767 HAWTHORNE CT
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-3016
Practice Address - Country:US
Practice Address - Phone:248-594-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012692101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401012692OtherLLPC