Individual provider Active NPI

Sharron Montague, LMSW

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1114553690
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801112424 Issued in MI
Practice address
4230 Copper Ridge Dr
Traverse City, MI 49684-7256
Phone
(231) 935-6380
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801112424 MI Primary
Clinical Social Worker 1041C0700X 6801103297 MI

Addresses

Primary practice location

4230 Copper Ridge Dr
Traverse City, MI 49684-7256

Mailing address

4230 Copper Ridge Dr
Traverse City, MI 49684-7256
Phone (231) 935-6380

Other practice location 1

3639 Cass Rd
Traverse City, MI 49684-9153
Phone (231) 227-2662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20250128000266 MI Practitioner - Clinical Social Worker 3678002235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

4230 Copper Ridge Dr
Traverse City, MI 49684-7256

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801103297MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Jan 25, 2026 Accepting new patients
Munson Medical Center CurrentSince Nov 4, 2024 Accepting new patients
Illuminate My Life Counseling Clinical CurrentSince Aug 8, 2021 Accepting new patients
Munson Medical Center CurrentSince Nov 4, 2024 Accepting new patients

Locations

2692 S M 37
Traverse City, MI 49685
Phone (231) 570-0627

4230 Copper Ridge Dr
Traverse City, MI 49684
Phone (231) 935-6380

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1114553690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 COPPER RIDGE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847256",
            "telephone_number": "231-935-6380",
            "fax_number": "231-935-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 COPPER RIDGE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847256",
            "telephone_number": "231-935-6380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3639 Cass Rd",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496849153",
            "country_code": "US",
            "telephone_number": "231-227-2662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "SHARRON",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801112424",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103297",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.