Jacklyn J Montero, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003864 Issued in GA

Practice address

175 Gwinnett Dr
Lawrenceville, GA 30045-8444

Phone

(770) 339-5377

Fax

(770) 339-5016

NPI assigned

Dec 17, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1063695757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 OAK HILL CIR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834211",
            "telephone_number": "404-538-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458444",
            "telephone_number": "770-339-5377",
            "fax_number": "770-339-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTERO",
        "first_name": "JACKLYN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Mong
• Carlina Monroy
• Samuel Montague
• Yolanda M Monteiro, LPC
• Aldemar Montero, M.D.
• Latoya Venise Montfort, ACAGNP
• David James Montgomery Jr.
• Dea Rabon Montgomery, PH.D.
• Sydney Nicole Montgomery
• Andrea Moody, LCSW

• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.