Organization Active NPI

Joanne L Montgomery, LLC

  • Clinical Social Worker
  • Milford, CT
National Provider Identifier
1215426903
Registry record updated Apr 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JOANNE L MONTGOMERY, LLC
Practice address
57 Plains Rd Ste 1E
Milford, CT 06461-2573
Phone
(203) 913-6439
NPI assigned
May 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2020

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

Authorized official

Name
Mrs. Joanne L MontgomeryNPI 1679096093
Title
LCSW
Phone
(203) 913-6439

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

57 Plains Rd Ste 1E
Milford, CT 06461-2573

Mailing address

11 Valley Brook Rd
West Haven, CT 06516-2946
Phone (203) 913-6439

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200629003452 CT Part B Supplier - Clinic/Group Practice 0749602274 Receives reassigned benefits from 3 practitioners
Practice locations: Milford, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587168000000",
    "number": "1215426903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 VALLEY BROOK RD",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162946",
            "telephone_number": "203-913-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PLAINS RD STE 1E",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064612573",
            "telephone_number": "203-913-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE L MONTGOMERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "203-913-6439",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.