Individual provider Active NPI

Judith Irene Montague, LCSW

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1144459504
Registry record updated Jul 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
67569253501 Issued in UT
Practice address
1111 Brickyard Rd Ste 109
Salt Lake City, UT 84106-2593
Phone
(801) 746-4334
Fax
(801) 746-4337
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 67569253501 UT Primary

Addresses

Primary practice location

1111 Brickyard Rd Ste 109
Salt Lake City, UT 84106-2593

Mailing address

1111 Brickyard Rd Ste 109
Salt Lake City, UT 84106-2593
Phone (801) 746-4334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
67569253501UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service Past Accepting new patients

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246924800000",
    "number": "1144459504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BRICKYARD RD STE 109",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062593",
            "telephone_number": "801-746-4334",
            "fax_number": "801-746-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BRICKYARD RD STE 109",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062593",
            "telephone_number": "801-746-4334",
            "fax_number": "801-746-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "JUDITH",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "67569253501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.