Provider Demographics
NPI:1265928741
Name:MONTGOMERY, BRITTNI (LISW)
Entity type:Individual
Prefix:
First Name:BRITTNI
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-2443
Mailing Address - Country:US
Mailing Address - Phone:216-231-7700
Mailing Address - Fax:216-231-3828
Practice Address - Street 1:12100 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1444
Practice Address - Country:US
Practice Address - Phone:216-851-2600
Practice Address - Fax:216-851-2600
Is Sole Proprietor?:No
Enumeration Date:2018-07-08
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.20023521041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical