Trena Rae Montgomery, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27339 Issued in MN

Practice address

2000 Aldrich Ave S
Minneapolis, MN 55405-3003

Phone

(218) 553-3885

NPI assigned

Jun 23, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1083345649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ORLIN AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143523",
            "telephone_number": "612-505-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ALDRICH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053003",
            "telephone_number": "218-553-3885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15816 Main Ave",
            "address_purpose": "LOCATION",
            "city": "Red Lake",
            "state": "MN",
            "postal_code": "566715667",
            "country_code": "US",
            "telephone_number": "218-679-3341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "TRENA",
        "middle_name": "RAE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Montes-Laracuente, L.AC.
• Alexandra Montes
• Sally Ann Montesinos, RN
• Dana Marie Montgomery Leatherman, RN
• Crystalin Rowe Montgomery, N.D., L.AC.
• Michael John Monti, DDS
• Cassandra Montney, M.S., CCC-SLP
• Kirsten Montray, PA-C
• Joshua Montrenes, PHD
• David J Monyak, M.D.

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.