Crystal Dawn Montgomery, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2015034790 Issued in MO

Practice address

615 N Broadview St Ste 102
Cape Girardeau, MO 63701-4372

Phone

(573) 334-2889

NPI assigned

Dec 30, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Denise Essners & Associates

  • Clinical Social Worker
  • Cape Girardeau, MO
  • NPI 1508078338
  NPD (past)

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

{
    "created_epoch": "1546128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546128000000",
    "number": "1083186175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 DAVID DR",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637557780",
            "telephone_number": "573-579-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N BROADVIEW ST STE 102",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014372",
            "telephone_number": "573-334-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-30",
        "last_updated": "2018-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2015034790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Modglin
• Ericka Renee Moehlenkamp, PLPC
• Alexi Nicole Moeller, PHARMD
• Stephanie Moll, APRN-FNP-BC
• Gina Monaco, M.D., PH.D.
• Emily Clare Montgomery
• Jazzmine Madison Moody
• Charles M. Moon, MD
• Andrew Jacob Moore, M.D.
• Brianna Claire Moore

• Clinical Social Worker in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.