Provider Demographics
NPI:1760930358
Name:MONTGOMERY, LAURYN HOPE (MA)
Entity type:Individual
Prefix:MRS
First Name:LAURYN
Middle Name:HOPE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 WESTMERE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4702
Mailing Address - Country:US
Mailing Address - Phone:317-853-9328
Mailing Address - Fax:
Practice Address - Street 1:1660 E MAIN ST STE 107B
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2816
Practice Address - Country:US
Practice Address - Phone:317-286-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IN39003757A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor