Active NPI
Russell Harold Montgomery, MA LPC
- Professional Counselor
- Houston, TX
National Provider Identifier
1053851527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 73514
- Practice address
- 1100 Nasa Pkwy Ste 201a
Houston, TX 77058-2813 - Phone
- (832) 581-5847
- NPI assigned
- Mar 3, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 73514 | TX | Primary |
| Professional Counselor | 101YP2500X | PCCI3743 | CA |
Addresses
Primary practice location
1100 Nasa Pkwy Ste 201a
Houston, TX 77058-2813
Mailing address
1100 Nasa Pkwy Ste 201a
Houston, TX 77058-2813
Phone (832) 581-5847
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 404002403 | Medicaid | TX |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCCI3743 | CA | MD | Professional Counselor |
| 73514 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1053851527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 NASA PKWY STE 201A",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770582813",
"telephone_number": "832-581-5847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 NASA PKWY STE 201A",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770582813",
"telephone_number": "832-581-5847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "RUSSELL",
"middle_name": "HAROLD",
"credential": "MA LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-03",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "73514",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "PCCI3743",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "404002403",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.