Marilyn Fenton Montville

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

237 Issued in WY

Practice address

721 Sheridan Ave
Suite 260
Cody, WY 82414-3423

Phone

(307) 527-5312

Fax

(307) 578-2212

NPI assigned

Jan 16, 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

Other identifiers 1

Other names 1

• Marilyn Fenton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376695023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 SHEPARD PL",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824144220",
            "telephone_number": "307-587-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SHERIDAN AVE",
            "address_2": "SUITE 260",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143423",
            "telephone_number": "307-527-5312",
            "fax_number": "307-578-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTVILLE",
        "first_name": "MARILYN",
        "middle_name": "FENTON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH UNIVERSAL CREDENTIAL",
            "identifier": "11661674",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "FENTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Cody, WY
• Providers in Cody, WY by specialty
• Mental Health Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.