Provider Demographics
NPI:1174708028
Name:MONTESANTO, GRETCHEN NOELLE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:NOELLE
Last Name:MONTESANTO
Suffix:
Gender:F
Credentials:MA, LPC
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Other - First Name:
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Mailing Address - Street 1:PO BOX 9909
Mailing Address - Street 2:1318 RAEFORD ROAD
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9094
Mailing Address - Country:US
Mailing Address - Phone:910-485-6336
Mailing Address - Fax:910-485-6572
Practice Address - Street 1:1318 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5482
Practice Address - Country:US
Practice Address - Phone:910-485-6336
Practice Address - Fax:910-485-6572
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC7356101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional