Provider Demographics
NPI:1174990683
Name:MONTGOMERY, REBEKAH (MS)
Entity type:Individual
Prefix:MS
First Name:REBEKAH
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10637 WEYMOUTH ST
Mailing Address - Street 2:APT 202
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4237
Mailing Address - Country:US
Mailing Address - Phone:240-543-7481
Mailing Address - Fax:
Practice Address - Street 1:1120 G ST NW
Practice Address - Street 2:SUITE 310
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3801
Practice Address - Country:US
Practice Address - Phone:202-628-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health