Individual provider Active NPI

Montanna Kirsten Williamson, LCSW

  • Clinical Social Worker
  • Cocoa, FL
National Provider Identifier
1144036617
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24965 Issued in FL
Practice address
505 Brevard Ave Ste 102
Cocoa, FL 32922-7973
Phone
(321) 632-5792
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW24965 FL Primary

Addresses

Primary practice location

505 Brevard Ave Ste 102
Cocoa, FL 32922-7973

Mailing address

505 Brevard Ave Ste 102
Cocoa, FL 32922-7973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260414002911 FL Practitioner - Clinical Social Worker 2163998519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M3 Haven Inc.Group PAC ID 9436698040, 7 clinicians

Practice addresses (Care Compare)

6769 N Wickham Rd
Suite B101
Melbourne, FL 32940-2048
Phone (321) 321-1490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW24965FLMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1144036617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 BREVARD AVE STE 102",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BREVARD AVE STE 102",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227973",
            "telephone_number": "321-632-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MONTANNA",
        "middle_name": "KIRSTEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.