Grayson Marie Montgomery, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P014883 Issued in NC

Practice address

2720 South Blvd Apt 349
Charlotte, NC 28209-1562

Phone

(919) 612-1132

NPI assigned

Aug 11, 2020

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

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617494400000",
    "number": "1124639505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 SOUTH BLVD APT 349",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091562",
            "telephone_number": "919-612-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SOUTH BLVD APT 349",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282091562",
            "telephone_number": "919-612-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "GRAYSON",
        "middle_name": "MARIE",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2021-04-04",
        "certification_date": "2021-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Rawlins Montes, PA
• Montgomery Group, LLC
• Alexandra Chanel Montgomery, MD
• Alexandria Nicole Montgomery, DNP
• David Len Montgomery, P.T.
• Kathryn Ann Montgomery, LCMHCA
• Kimberly Nesbitt Montgomery, FNP
• Monique M Montgomery, LCSW, LCDP
• Samuel Montgomery
• Tchernavia Ranesfore Montgomery, MSW, LCSW

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2021; 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.