Provider Demographics
NPI:1669428389
Name:MONTEITH, INGRID V (MA, LPCC-S, NCC)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:V
Last Name:MONTEITH
Suffix:
Gender:F
Credentials:MA, LPCC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 CHART RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2833
Mailing Address - Country:US
Mailing Address - Phone:330-928-1592
Mailing Address - Fax:
Practice Address - Street 1:85 COMMUNITY RD
Practice Address - Street 2:SUITE F
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2356
Practice Address - Country:US
Practice Address - Phone:330-633-1206
Practice Address - Fax:330-633-1364
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0002325101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00000389868OtherANTHEM