Provider Demographics
NPI:1457793630
Name:MONTGOMERY, JOYRE AMBRELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:JOYRE
Middle Name:AMBRELLE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOYRE
Other - Middle Name:AMBRELLE
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:809 N VALLEYWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-2448
Mailing Address - Country:US
Mailing Address - Phone:423-903-8018
Mailing Address - Fax:
Practice Address - Street 1:6727 HERITAGE BUSINESS CT STE 720
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2597
Practice Address - Country:US
Practice Address - Phone:423-314-7768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 1041S0200X, 171M00000X
TN72701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator