Active NPI
Mark Alan Montgomery, LPC
- Professional Counselor
- Austin, TX
National Provider Identifier
1518152610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17050
- Practice address
- 1011 W 31St St
Suite 24
Austin, TX 78705-2099 - Phone
- (512) 445-7974
- NPI assigned
- Sep 11, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 17050 | TX | Primary |
Addresses
Primary practice location
1011 W 31St St
Suite 24
Austin, TX 78705-2099
Mailing address
PO Box 295
Weir, TX 78674-0295
Phone (512) 445-7974
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17050 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189468800000",
"number": "1518152610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 295",
"city": "WEIR",
"state": "TX",
"postal_code": "786740295",
"telephone_number": "512-445-7974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 W 31ST ST",
"address_2": "SUITE 24",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787052099",
"telephone_number": "512-445-7974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "MARK",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-11",
"last_updated": "2007-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "17050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.