Provider Demographics
NPI:1184501843
Name:MONTGOMERY, BETH ANN (LCSW, MSW)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 EMANCIPATION HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8407
Mailing Address - Country:US
Mailing Address - Phone:540-478-8008
Mailing Address - Fax:540-212-2660
Practice Address - Street 1:615 EMANCIPATION HWY STE 101
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8407
Practice Address - Country:US
Practice Address - Phone:540-478-8008
Practice Address - Fax:540-212-2660
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040189411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical