Provider Demographics
NPI:1669084513
Name:MONTAVON, JANE KATHRYN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:KATHRYN
Last Name:MONTAVON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4800 ROWAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-5609
Mailing Address - Country:US
Mailing Address - Phone:727-483-5912
Mailing Address - Fax:727-376-3652
Practice Address - Street 1:17222 HOSPITAL BLVD STE 226
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-8925
Practice Address - Country:US
Practice Address - Phone:352-678-5550
Practice Address - Fax:352-678-5551
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSW17055101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health