Loretta Baker-Montgomery, LCSW
Individual provider Active NPI Clinical Social Worker · Fordland, MO
NPI 1023210911 · NPPES record last updated Jun 1, 2026
Key facts
- NPI
- 1023210911
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2003017994 (MO)
- Practice address
- 1059 Barton Dr
Fordland, MO 65652-7350 - Phone
- (417) 767-2273
- Fax
- (417) 767-4054
- NPI assigned
- Jun 3, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mental Health Specialty Group PA
Big Springs Medical Association
Practice addresses (Care Compare)
10304 Bust Subdivision Rd
Potosi, MO 63664-8361
Phone (323) 205-7088
17959 Main St
Eminence, MO 65466-6375
Phone (573) 226-5505
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190926000775 | MO | Practitioner - Clinical Social Worker | 3072737063 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003017994 | MO | MD | Clinical Social Worker |
Practice roles (6 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fordland Clinic, Inc. | Current |
Accepting new patients | |
| Big Springs Medical Association | Current | Accepting new patients | |
| Big Springs Medical Association | Current |
Accepting new patients | |
| Big Springs Medical Association | Current |
Accepting new patients | |
| Mental Health Specialty Group PA | Current |
Accepting new patients | |
| Fordland Clinic, Inc. | Current |
Accepting new patients |
Locations
202 Allen St
Annapolis, MO 63620
Phone (573) 598-4213
3277 US Highway 160 W
Doniphan, MO 63935
109 Plum St
Doniphan, MO 63935
Phone (573) 776-2136
109 Plum St
Ste B
Doniphan, MO 63935
Phone (573) 351-0220
109 Leroux St
Doniphan, MO 63935
Phone (573) 996-2136
61 Highway Y
Ellington, MO 63638
Phone (573) 663-2525
1059 Barton Dr
Fordland, MO 65652
Phone (417) 767-2100
11863 State Highway 13
Ste 1
Kimberling City, MO 65686
Phone (417) 739-2520
1 Hals Plz
Piedmont, MO 63957
Phone (573) 223-4800
2210 Barron Rd
Ste 120
Poplar Bluff, MO 63901
Phone (573) 785-2005
2879 James Blvd
Poplar Bluff, MO 63901
Phone (573) 609-8800
18 Viburnum Center Rd
Viburnum, MO 65566
Phone (573) 244-5406
Networks
- IA HMO
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
- IA HMO C-SNP
Interoperability endpoints
- loretta.baker-montgomery.1@14422.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2003017994 | MO | Yes |
Addresses
Primary practice location
1059 Barton Dr
Fordland, MO 65652-7350
Mailing address
1059 Barton Dr
Fordland, MO 65652-7350
Phone (417) 767-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023210911 | Medicaid | MO |
Other providers in Fordland, MO
All providers in Fordland, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.