Individual provider Active NPI

Joanne Lillian Montgomery, LADC, MSW

  • Addiction (Substance Use Disorder) Counselor
  • Milford, CT
National Provider Identifier
1679096093
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
001242 Issued in CT
Practice address
57 Plains Rd Ste 1E
Milford, CT 06461-2573
Phone
(203) 913-6439
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 001242 CT Primary

Addresses

Primary practice location

57 Plains Rd Ste 1E
Milford, CT 06461-2573

Mailing address

11 Valley Brook Rd
West Haven, CT 06516-2946
Phone (203) 931-1593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200629003581 CT Practitioner - Clinical Social Worker 1658793187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joanne L Montgomery LLCGroup PAC ID 0749602274, 2 clinicians

Practice addresses (Care Compare)

57 Plains Rd
Suite 1E
Milford, CT 06461-2573
Phone (203) 913-6439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001242CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joanne L Montgomery, LLC Addiction (Substance Use Disorder) CurrentSince Apr 18, 2020 Accepting new patients

Locations

57 Plains Rd
Ste 1E
Milford, CT 06461
Phone (203) 500-8339

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": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1679096093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 VALLEY BROOK RD",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162946",
            "telephone_number": "203-931-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PLAINS RD STE 1E",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064612573",
            "telephone_number": "203-913-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JOANNE",
        "middle_name": "LILLIAN",
        "credential": "LADC, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "001242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.