Krishawna Elaine Montgomery, LPC, NCC
Individual provider Active NPI Professional Counselor · Lafayette, GA
NPI 1083987481 · NPPES record last updated Jul 12, 2019
Key facts
- NPI
- 1083987481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC008188 (GA)
- Practice address
- 501 Mize Street Lookout Mountain Community Services
Lafayette, GA 30728 - Phone
- (706) 638-5580
- Fax
- (706) 638-5445
- NPI assigned
- Feb 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Highland Rivers Community Service Board
Practice addresses (Care Compare)
6 Mathis Dr NW
Suite B
Rome, GA 30165-1242
Phone (706) 233-9023
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20240110002326 | GA | Practitioner - Mental Health Counselor | 1759732142 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC008188 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Rivers Community Service Board | Current |
Accepting new patients | |
| Highland Rivers CSB | Current |
Accepting new patients |
Locations
191 Lamar Haley Pkwy
Canton, GA 30114
Phone (770) 704-1600
1503 N Tibbs Rd
Dalton, GA 30720
Phone (706) 229-4507
6 Mathis Dr NW
Ste B
Rome, GA 30165
Phone (706) 233-9023
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC008188 | GA | Yes |
Addresses
Primary practice location
501 Mize Street Lookout Mountain Community Services
Lafayette, GA 30728
Mailing address
51 Crosscreek Dr NW
Rome, GA 30165-1202
Phone (706) 331-2235
Other providers in Lafayette, GA
- Lookout Mountain Community Services
- Janet Audrey McCollough
- Medi Thrift Inc
- Medi Thrift Inc
- Leah Harris Miller
- Albert B Nichols
- Heidi Septor
- Clayton Smith
- Gwendolyn W. Smith
- William Randall Smith
All providers in Lafayette, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2019. 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.