LAQUAWN MONTGOMERY (NPI# 1558762146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558762146 |
| Entity Type | Individual |
| Full Name | LAQUAWN MONTGOMERY |
| Practice Address |
96 Wisteria Rd Goose Creek SC 29445-3495 |
| Practice Telephone | 8437977871 |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Street Address |
96 WISTERIA RD |
| City | GOOSE CREEK |
| State | SC |
| Zip Code | 29445-3495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154365005 | Frank D Strange IIi | Social Worker | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2006-06-15 |
| 1295336212 | Lakia Jones | Counselor | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2020-11-05 |
| 1982217246 | Ernest Kennedy Center | Counselor | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2020-08-26 |
| 1972098960 | Ohio Valley Physicians Inc | Family Medicine | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2018-06-22 |
| 1003367905 | Terrell Montague | Counselor | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2016-10-17 |
| 1780134668 | Kevin Branson | Counselor | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2016-10-04 |
| 1457769440 | Jaunita Cunningham Wragg | Counselor | 96 Wisteria Rd, Goose Creek, SC 29556 | 2014-07-23 |
| 1881002715 | Shanna Freeman | Counselor | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2014-07-23 |
| 1306253471 | Kianga Green | Counselor | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2014-07-21 |
| 1891132338 | Mylin Sinlker | Counselor | 96 Wisteria Rd, Goose Creek, SC 29445-3495 | 2013-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790309953 | Auriel Mcconnell | Home Health | 616 One Mans Court, Mount Pleasant, SC 29445 | 2020-06-03 |
| 1215594023 | Tanova Cornise Robinson | Counselor | 96 Wisteria Road, Goose Creek, SC 29445 | 2019-05-28 |
| 1417421777 | Debra Liana Kerness | Social Worker | 100-a Central Avenue, Suite 203, Goose Creek, SC 29445 | 2019-01-18 |
| 1043663503 | Aimee Nehiley | Dentist | 615 Saint James Ave, Goose Creek, SC 29445 | 2016-07-20 |
| 1881057032 | Eddie Emanuel Nance | Family Medicine | 110 Naval Nuclear Power Training Command Cir, Goose Creek, SC 29445 | 2016-04-04 |
| 1295195188 | Dental Professionals of South Carolina, PC | Dentist | 615 St. James Ave, Goose Creek, SC 29445 | 2016-03-04 |
| 1144603622 | Laryssa Smith | Pharmacist | 215 St. James Ave, Goose Creek, SC 29445 | 2015-07-02 |
| 1730439126 | O'stacia Williamson | Pharmacist | 1316 Redbank Rd, 9, Goose Creek, SC 29445 | 2012-09-13 |
| 1164771275 | Mary Ashley Watts | Pharmacist | 431 B St James Ave Suite I, Goose Creek, SC 29445 | 2012-09-05 |
| 1598048860 | Brianne Michele Terry | Pharmacist | 142 East Saint James Ave, Goose Creek, SC 29445 | 2011-09-23 |
| Find all providers in zip 29445 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689143646 | Horizon Medical Group | Substance Abuse Rehabilitation Facility | 6941 N Trenholm Rd Ste I, Columbia, SC 29206-1730 | 2018-11-20 |
| City | GOOSE CREEK |
| Zip Code | 29445 |
Please comment or provide details below to improve the information on LAQUAWN MONTGOMERY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.