Provider Demographics
NPI:1932971272
Name:MONTOYA, THERESA E (LMSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:E
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14162 COQUINA BAY AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6563
Mailing Address - Country:US
Mailing Address - Phone:361-608-8245
Mailing Address - Fax:
Practice Address - Street 1:5934 S STAPLES ST STE 230
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3800
Practice Address - Country:US
Practice Address - Phone:361-608-8245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT665801041C0700X
TX665801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical