Active NPI
Susan Elizabeth Montgomery, MA LMHC
- Mental Health Counselor
- Brookline, MA
National Provider Identifier
1265571657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 5088
- Practice address
- 1863 Beacon St
Brookline, MA 02445-4270 - Phone
- (617) 983-0875
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5088 | MA | Primary |
Addresses
Primary practice location
1863 Beacon St
Brookline, MA 02445-4270
Mailing address
20 Edge Hill St
Jamaica Plain, MA 02130-1246
Phone (617) 983-0875
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 |
|---|---|---|---|
| 5088 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312934400000",
"number": "1265571657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 EDGE HILL ST",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021301246",
"telephone_number": "617-983-0875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1863 BEACON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024454270",
"telephone_number": "617-983-0875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"credential": "MA LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2011-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "5088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.