NPIMap

Individual provider Active NPI

Kelli Ann Montejo, BS

  • Counselor
  • Lowell, MA
National Provider Identifier
1821150103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
RC00050399 Issued in WA
Practice address
148 Warren St
Lowell, MA 01852
Phone
(978) 452-1736
Fax
(978) 452-6625
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X RC00050399 WA Primary

Addresses

Primary practice location

148 Warren St
Lowell, MA 01852

Mailing address

105 Wimbledon Crossing
Dracut, MA 01826
Phone (978) 455-9702

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
RC00050399WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Mental Health Center Past Accepting new patients

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821150103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WIMBLEDON CROSSING",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "01826",
            "telephone_number": "978-455-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WARREN ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01852",
            "telephone_number": "978-452-1736",
            "fax_number": "978-452-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEJO",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00050399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.