Active NPI
Gretal Jean Montgomery, M.A.
- Psychologist
- Detroit, MI
National Provider Identifier
1255452082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301014125
- Practice address
- 751 E Grand Blvd
Detroit, MI 48207-2529 - Phone
- (313) 922-2222
- Fax
- (313) 922-8771
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301014125 | MI | Primary |
Addresses
Primary practice location
751 E Grand Blvd
Detroit, MI 48207-2529
Mailing address
440 W 17TH Avenue
Vancouver, BC V5Y 2A2
CA
Phone (778) 883-8527
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301014125 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1255452082",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "440 W 17TH AVENUE",
"city": "VANCOUVER",
"state": "BC",
"postal_code": "V5Y 2A2",
"telephone_number": "778-883-8527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 E GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482072529",
"telephone_number": "313-922-2222",
"fax_number": "313-922-8771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "GRETAL",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301014125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.