Provider Demographics
NPI:1487960266
Name:MONTALVO, CYNTHIA REICH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:REICH
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 CENTURY DR UNIT E
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-8379
Mailing Address - Country:US
Mailing Address - Phone:770-475-0461
Mailing Address - Fax:770-475-0461
Practice Address - Street 1:12700 CENTURY DR UNIT E
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8379
Practice Address - Country:US
Practice Address - Phone:770-475-0461
Practice Address - Fax:770-475-0461
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0005241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical