Individual provider Active NPI

Joyre Ambrelle Montgomery, LCSW

  • Clinical Social Worker
  • Chattanooga, TN
National Provider Identifier
1457793630
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7270 Issued in TN
Practice address
6727 Heritage Business CT Ste 720
Chattanooga, TN 37421-2597
Phone
(423) 314-7768
NPI assigned
Jul 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
School Social Worker 1041S0200X
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 7270 TN Primary

Addresses

Primary practice location

6727 Heritage Business CT Ste 720
Chattanooga, TN 37421-2597

Mailing address

809 N Valleywood Cir
Hixson, TN 37343-2448
Phone (423) 903-8018

Other practice location 1

809 N Valleywood Cir
Hixson, TN 37343-2448
Phone (423) 314-7768

Other names 1

  • Joyre Ambrelle Sims Former name

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

State licenses

LicenseStateTypeSpecialty
7270TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Intentional Healing Empowerment Center, LLC Mental Health CurrentSince Aug 2, 2020 Accepting new patients

Locations

6727 Heritage Business Ct
Ste 720
Chattanooga, TN 37421
Phone (423) 314-7768

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1457793630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N VALLEYWOOD CIR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373432448",
            "telephone_number": "423-903-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6727 HERITAGE BUSINESS CT STE 720",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212597",
            "telephone_number": "423-314-7768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 N Valleywood Cir",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373432448",
            "country_code": "US",
            "telephone_number": "423-314-7768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JOYRE",
        "middle_name": "AMBRELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOYRE",
            "last_name": "SIMS",
            "middle_name": "AMBRELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.