Active NPI
Michael Andrew Montgomery, LCSW
- Clinical Social Worker
- Wellsville, UT
National Provider Identifier
1003005166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7334775-3501
- Practice address
- 7877 S Highway 89 # 91
Wellsville, UT 84339-9416 - Phone
- (385) 388-7930
- NPI assigned
- Oct 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7334775-3501 | UT | Primary |
Addresses
Primary practice location
7877 S Highway 89 # 91
Wellsville, UT 84339-9416
Mailing address
7877 S Highway 89 # 91
Wellsville, UT 84339-9416
Phone (385) 388-7930
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 876000308007 | Medicaid | UT | |
| 260022408 | Other | UT | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7334775-3501 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellsville Recovery | Current | Accepting new patients | |
| Aloha Medical Services, LLC | Past | Accepting new patients | |
| Aloha Behavioral Consultants, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- Wellsville, UT
- NPI 1891451712
-
- Multi-Specialty Clinic/Center
- Harrisville, UT
- NPI 1255956967
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1003005166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7877 S HIGHWAY 89 # 91",
"city": "WELLSVILLE",
"state": "UT",
"postal_code": "843399416",
"telephone_number": "385-388-7930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7877 S HIGHWAY 89 # 91",
"city": "WELLSVILLE",
"state": "UT",
"postal_code": "843399416",
"telephone_number": "385-388-7930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "MICHAEL",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-15",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "7334775-3501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "876000308007",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "260022408",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wellsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.