Individual provider Active NPI

Pamella A Montgomery, LSW, ACSW

  • Clinical Social Worker
  • Okemos, MI
National Provider Identifier
1386614006
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801000545 Issued in MI
Practice address
3887 Okemos Rd
Suite A4
Okemos, MI 48864-3664
Phone
(517) 381-0111
Fax
(517) 381-0444
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 6801000545 MI Primary

Addresses

Primary practice location

3887 Okemos Rd
Suite A4
Okemos, MI 48864-3664

Mailing address

3887 Okemos Rd
Suite A4
Okemos, MI 48864-3664
Phone (517) 381-0111

Other identifiers 1

IdentifierTypeStateIssuer
80OC311530OtherMIBCBS PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040412000843 MI Practitioner - Clinical Social Worker 6709870926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3800 Heritage Ave
Suite A2
Okemos, MI 48864-2871
Phone (517) 347-7736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801000545MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Psychiatric Consultants, PC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386614006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3887 OKEMOS RD",
            "address_2": "SUITE A4",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643664",
            "telephone_number": "517-381-0111",
            "fax_number": "517-381-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3887 OKEMOS RD",
            "address_2": "SUITE A4",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643664",
            "telephone_number": "517-381-0111",
            "fax_number": "517-381-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "PAMELLA",
        "middle_name": "A",
        "credential": "LSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801000545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "80OC311530",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.