| Linda Ray Montgomery, LPC | |
| 
					380 Washington Street, Boydton, VA 23970  | |
| (434) 738-6102 | |
| (434) 738-6982 | 
| Full Name | Linda Ray Montgomery | 
|---|---|
| Gender | Female | 
| Speciality | Counselor | 
| Location | 380 Washington Street, Boydton, Virginia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1912931536 | NPI | - | NPPES | 
| 238474 | Other | VA | ANTHEM | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101Y00000X | Counselor | 0701002899 (Virginia) | Primary | 
| Entity Name | Southside Behavioral Health | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1700890761 PECOS PAC ID: 4284660507 Enrollment ID: O20050708000612  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Linda Ray Montgomery, LPC 380 Washington Street, Boydton, VA 23970 Ph: (434) 738-6102  | Linda Ray Montgomery, LPC 380 Washington Street, Boydton, VA 23970 Ph: (434) 738-6102  | 
T'onna Logan,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 1897 Ridge Rd, Boydton, VA 23917 Phone: 434-210-8264  | |
Laura Smith, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 450 Washington Street, Boydton, VA 23917 Phone: 434-738-0406  | |
Emily Spence,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 450 Washington Street, Boydton, VA 23917 Phone: 434-738-0406 Fax: 434-738-0409  | |
Ms. Angela Poythress, LPC Counselor Medicare: Medicare Enrolled Practice Location: 523 Madison St., Boydton, VA 23917 Phone: 434-738-0154 Fax: 434-572-4881  | |
Makayla Bing,  Counselor Medicare: Medicare Enrolled Practice Location: 450 Washington St., Boydton, VA 23917 Phone: 434-738-0406  |