Individual provider Active NPI

Jennifer L Montgomery, LCSW

  • Clinical Social Worker
  • Dover, DE
National Provider Identifier
1295543932
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0012630 Issued in DE
Practice address
1198 S Governors Ave Ste 201
Dover, DE 19904-6930
Phone
(302) 382-8698
NPI assigned
Dec 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 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 Q1-0012630 DE Primary

Addresses

Primary practice location

1198 S Governors Ave Ste 201
Dover, DE 19904-6930

Mailing address

1198 S Governors Ave Ste 201
Dover, DE 19904-6930
Phone (302) 382-8698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20250303002314 DE Practitioner - Clinical Social Worker 2769903053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Mental Edge Counseling, LLCGroup PAC ID 2668750324, 21 clinicians

Practice addresses (Care Compare)

1198 S Governors Ave
Suite 201
Dover, DE 19904-6930
Phone (302) 382-8698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0012630DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Edge Counseling, LLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

1198 S Governors Ave
Ste 201
Dover, DE 19904
Phone (302) 382-8698

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": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1295543932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1198 S GOVERNORS AVE STE 201",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199046930",
            "telephone_number": "302-382-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 S GOVERNORS AVE STE 201",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199046930",
            "telephone_number": "302-382-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-27",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0012630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.