Clarence Montgomery III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17466-130 Issued in WI

Practice address

1111 S 6TH St
1111 S.6TH St.
Milwaukee, WI 53204-2301

Phone

(414) 649-0189

Fax

(414) 647-8602

NPI assigned

Jun 1, 2015

Last updated

Jun 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1659751162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S 6TH ST",
            "address_2": "1111 S.6TH ST.",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042301",
            "telephone_number": "414-649-0189",
            "fax_number": "414-647-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S 6TH ST",
            "address_2": "1111 S.6TH ST.",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042301",
            "telephone_number": "414-649-0189",
            "fax_number": "414-647-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CLARENCE",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17466-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Jacob Montes, DDS
• Grace Elizabeth Montes, MD
• Jennifer Crystal Montes, DNP, APNP, FNP-BC
• Stephanie Montes, LMT
• Christopher Montezon
• Jennifer L Montgomery, MS
• Nicole Montgomery
• Robert R Montgomery, MD
• Sophia Grace Montgomery, DDS
• Michael James Montie, D.O.

• Addiction (Substance Use Disorder) Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.