Susan L Montgomery, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111611 Issued in MA

Practice address

923 Route 6a Unit N
Yarmouth Port, MA 02675-2159

Phone

(508) 362-4250

NPI assigned

Dec 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Barnstable Counseling Associates, LLC

  • Psychiatry Physician
  • Yarmouth Port, MA
  • NPI 1760573034

  Clinical

  NPD (past) Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073679676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 ROUTE 6A UNIT N",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026752159",
            "telephone_number": "508-362-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 ROUTE 6A UNIT N",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026752159",
            "telephone_number": "508-362-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN ID",
            "identifier": "468743",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA ID",
            "identifier": "P08270",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meeting House Family Counseling
• Walter H. Meinzer II, D.D.S
• Melissa Hyer-Mitchell Psychotherapy LLC
• Yanasia A Mendes
• Meredith Reilly, LMHC LLC
• Audrey Motta-Wurst, M.S.
• Asahi Irene Nagasaka
• Carlos A Negron
• Joe A Nguyen, D.M.D.
• Leif R. Norenberg, M.D.

• Clinical Social Worker in Yarmouth Port, MA
• Providers in Yarmouth Port, MA by specialty
• Clinical Social Worker in Massachusetts

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.