MR. MARK ALYN MONTGOMERY (NPI# 1851478564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851478564 |
| Entity Type | Individual |
| Full Name | MR. MARK ALYN MONTGOMERY |
| Credential | LPC, LISAC |
| Practice Address |
4554 E. Inverness Ave., C-108 Mesa AZ 85206-4639 |
| Mailing Address |
4554 E Inverness Ave # C-108 Mesa AZ 85206-4639 |
| Practice Telephone | 4803305031 |
| Practice Fax Number | 4809262326 |
| Mailing Telephone | 4803305031 |
| Mailing Fax Number | 4809262326 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LISAC-1677 | AZ | Behavioral Health & Social Service Providers |
| X | 101YM0800X |
Counselor Specialization: Mental Health |
LPC-2087 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | LICENSED PROF. COUNSELOR | LPC-2087 | 01 |
| AZ | LIC. IND. SUB. ABUSE COUN | LISAC-1677 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548486905 | Mark R Montgomery | Dentist | 130 W Jackson St, Cicero, IN 46034 | 2007-04-17 |
| 1306261367 | Mark Montgomery | Pharmacy Technician | 1149 University Dr, Burlington, NC 27215-8798 | 2014-02-28 |
| 1518152610 | Mark Alan Montgomery | Counselor | 1011 W 31st St, Suite 24, Austin, TX 78705-2099 | 2007-09-11 |
| 1043413024 | Mark N. Montgomery | Dentist | 32241 Crown Valley Pkwy, Suite 240, Monarch Beach, CA 92629-3346 | 2007-06-07 |
| 1558424309 | Mark Woodrow Montgomery | Dentist | 925 Commercial St Se, Suite 240, Salem, OR 97302 | 2006-12-19 |
| 1528012655 | Mark Harlow Montgomery | Otolaryngology | 9240 Bonita Beach Rd, Suite 1106, Bonita Springs, FL 34135-4249 | 2006-05-22 |
| 1366403347 | Mark L. Montgomery | Radiology | 2401 S 31st St, Temple, TX 76508-0001 | 2006-03-30 |
| Street Address |
4554 E. INVERNESS AVE., C-108 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-4639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932725504 | Cheryl Hawley | Counselor | 2727 S Sawyer Cir, Mesa, AZ 85209-6257 | 2020-06-19 |
| 1578192357 | Katherine Desio-scott | Counselor | 9860 E Escondido Ave, Mesa, AZ 85208-3129 | 2020-04-03 |
| 1821639642 | Arizona Intergrated Tele Psychiatry and Tele Medicine Services LLC | Counselor | 2735 E Main St Ste 3, Mesa, AZ 85213-9269 | 2019-10-02 |
| 1881253961 | Amy Massey | Counselor | 522 W Edgewood Ave, Mesa, AZ 85210-3509 | 2019-06-11 |
| 1538630009 | Community Medical Services Arizona-private, LLC | Counselor | 2940 E Main St, Mesa, AZ 85213-9305 | 2018-12-10 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1780137729 | Maxine Mandell | Counselor | 3130 E Caballero St, Mesa, AZ 85213-7902 | 2016-07-26 |
| 1457726036 | Laura Fontaine | Counselor | 2345 S Alma School Rd Ste 105, Mesa, AZ 85210-4013 | 2015-12-07 |
| 1144625765 | Elevate Arizona | Counselor | 3208 N Ladera Cir, Mesa, AZ 85207-0810 | 2014-10-24 |
| 1013311356 | Chad H Close | Counselor | 650 W. Southern Ave., Mesa, AZ 85210 | 2014-10-15 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.