Pauline Montemayor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05611600 Issued in NJ

Practice address

129 Valley Rd
Montclair, NJ 07042-2331

Phone

(862) 210-2055

NPI assigned

Nov 4, 2013

Sex

Female

Sole proprietor

Yes

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)

Enrolled

State licenses

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1801225461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 BROAD ST APT K4",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032859",
            "telephone_number": "973-670-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422331",
            "telephone_number": "862-210-2055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 E Jersey St",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072061259",
            "country_code": "US",
            "telephone_number": "908-994-7040",
            "fax_number": "908-994-7247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTEMAYOR",
        "first_name": "PAULINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05611600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montclair State University Occupational Health
• Montclair Surgical Services LLC
• Montclair Therapy Associates LLC
• Montclair Upper Cervical Chiropractic, LLC
• Montclair Vision Services
• Ryan John Montes, PSY.D.
• Patience Moore, LCSW
• Carlos Mora, MD
• Stephanie Mora, LCSW
• Christine Morales, LCSW

• All providers in Montclair, NJ
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.