Provider Demographics
NPI:1679117568
Name:MONTGOMERY, SUMMER (PLPC)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:
Other - Last Name:HURSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:300 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-1410
Mailing Address - Country:US
Mailing Address - Phone:816-508-1700
Mailing Address - Fax:816-508-1763
Practice Address - Street 1:8150 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5806
Practice Address - Country:US
Practice Address - Phone:816-508-3500
Practice Address - Fax:816-508-3535
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019039985101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional