Michael Montie Lcsw Llc | |
280 N Providence Rd Ste 106 Media PA 19063-3530 | |
(610) 389-4531 | |
Not Available |
Full Name | Michael Montie Lcsw Llc |
---|---|
Speciality | Social Worker |
Location | 280 N Providence Rd Ste 106, Media, Pennsylvania |
Authorized Official Name and Position | Michael Montie (OWNER) |
Authorized Official Contact | 6103894531 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Michael Montie Lcsw Llc 1111 Belfield Ave. Drexel Hill PA 19026 Ph: () - | Michael Montie Lcsw Llc 280 N Providence Rd Ste 106 Media PA 19063-3530 Ph: (610) 389-4531 |
NPI Number | 1730731035 |
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Provider Enumeration Date | 07/16/2019 |
Last Update Date | 07/16/2019 |
Medicare PECOS PAC ID | 9133456668 |
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Medicare Enrollment ID | O20190807000419 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730731035 | NPI | - | NPPES |
CW013107 | Other | PA | 1295750610 |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Michael Montie |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1295750610 PECOS PAC ID: 0143276493 Enrollment ID: I20050330000036 |
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