Active NPI
James Otis Montford Jr., COUNSELOR,PHD
- Professional Counselor
- Douglasville, GA
National Provider Identifier
1700445475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 08189678
- Practice address
- 5357 Chapel Hill Rd
Douglasville, GA 30135-5027 - Phone
- (770) 942-4742
- NPI assigned
- Jun 6, 2019
- 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 | 08189678 | GA | Primary |
Addresses
Primary practice location
5357 Chapel Hill Rd
Douglasville, GA 30135-5027
Mailing address
5357 Chapel Hill Rd
Douglasville, GA 30135-5027
Phone (770) 942-4742
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08189678 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revival Counseling Services Incorporated | Past | Accepting new patients | |
| Life Tools Community Development Corporation | 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.
-
- Clinical Social Worker
- Douglasville, GA
- NPI 1053978700
-
- Clinical Social Worker
- Douglasville, GA
- NPI 1831647213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1700445475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5357 CHAPEL HILL RD",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301355027",
"telephone_number": "770-942-4742",
"fax_number": "770-293-0786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5357 CHAPEL HILL RD",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301355027",
"telephone_number": "770-942-4742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTFORD",
"first_name": "JAMES",
"middle_name": "OTIS",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "COUNSELOR,PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-06",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "08189678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.