Provider Demographics
NPI:1174809560
Name:MONTESINOS, STEVEN (MA, LMHC)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:MONTESINOS
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 SALISBURY RD
Mailing Address - Street 2:SUITE 242
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6107
Mailing Address - Country:US
Mailing Address - Phone:904-701-4662
Mailing Address - Fax:
Practice Address - Street 1:4720 SALISBURY RD STE 242
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6101
Practice Address - Country:US
Practice Address - Phone:904-701-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-29
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10873101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health