Provider Demographics
NPI:1427760420
Name:MONTOYA, CARINA (LSW)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:
Other - Last Name:BRODSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-0032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12620 LARCHMERE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1110
Practice Address - Country:US
Practice Address - Phone:216-279-0398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2208453104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker