Provider Demographics
NPI:1427691955
Name:MONTGOMERY, CLAIRE ELIZABETH ANN (LPCC)
Entity type:Individual
Prefix:MISS
First Name:CLAIRE
Middle Name:ELIZABETH ANN
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W SUPERIOR ST STE 730
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1720
Mailing Address - Country:US
Mailing Address - Phone:218-216-7805
Mailing Address - Fax:
Practice Address - Street 1:324 W SUPERIOR ST STE 730
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1720
Practice Address - Country:US
Practice Address - Phone:218-216-7805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN03019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health