Brooklyn Montgomery, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10064-C Issued in AR

Practice address

809 W Main St Ste C
Trumann, AR 72472-2634

Phone

(870) 483-0068

Fax

(870) 483-0066

NPI assigned

Sep 24, 2020

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

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.

Medicare enrollment (NPD)

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.

• Life Strategies Counseling, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Jonesboro, AR
  • NPI 1932154945
  NPD (past)
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1053298711
  NPD (past)

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1093322927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 FOREST HOME RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015320",
            "telephone_number": "866-972-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W MAIN ST STE C",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724722634",
            "telephone_number": "870-483-0068",
            "fax_number": "870-483-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "BROOKLYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "10064-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miracle Kids Success Academy of Trumann
• Miracle Kids Success Academy of Trumann
• Miracle Kids Success Academy of Trumann
• Miracle Kids Success Academy of Trumann
• Andrea Jordan Monreal
• Diana Michelle Montgomery, APN
• Kimberly Moody
• Taylor Patrick Moore, LPC
• Karen D Morris
• Muse Family Practice

• Clinical Social Worker in Trumann, AR
• Providers in Trumann, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.