Monique M Montgomery, LCSW, LCDP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009655 Issued in NC

Practice address

7825 Ballantyne Commons Pkwy
Suite 110
Charlotte, NC 28277-3174

Phone

(704) 446-0271

Fax

(704) 348-4057

NPI assigned

Aug 27, 2010

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1770899742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 BALLANTYNE COMMONS PKWY",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773174",
            "telephone_number": "704-446-0271",
            "fax_number": "704-348-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 BALLANTYNE COMMONS PKWY",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773174",
            "telephone_number": "704-446-0271",
            "fax_number": "704-348-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "MONIQUE",
        "middle_name": "M",
        "credential": "LCSW, LCDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009655",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "LCDP00473",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW01506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1274",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770899742",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Nicole Montgomery, DNP
• David Len Montgomery, P.T.
• Grayson Marie Montgomery, LCSWA
• Kathryn Ann Montgomery, LCMHCA
• Kimberly Nesbitt Montgomery, FNP
• Samuel Montgomery
• Tchernavia Ranesfore Montgomery, MSW, LCSW
• Thomas Montgomery, MD
• Tia Michele Montiero
• Jenna Simonne Montminy, DMD

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.