Kimberley Sue Montgomery, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

254519 Issued in KY

Practice address

322 N Main St
Kokomo, IN 46901-4622

Phone

(765) 453-8238

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1720129117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N MAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N MAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014622",
            "telephone_number": "765-453-8238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10101 Linn Station Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402233818",
            "country_code": "US",
            "telephone_number": "502-589-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KIMBERLEY",
        "middle_name": "SUE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007283A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Mohr, MD
• Ben Mohrman, DDS
• Momentum Kokomo, LLC
• Megan Mongosa, RBT
• Rikki Monson-Erb
• Susan W Moody, LCSW, LCAC, RPT
• Alyssa Marie Moon
• Moore Drug Store, Inc.
• Moore Drug Store, Inc.
• Alexia Moore

• Clinical Social Worker in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.