Individual provider Active NPI

Robert H Montgomery, LICSW CADAC

  • Addiction (Substance Use Disorder) Counselor
  • Woburn, MA
National Provider Identifier
1821191123
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0873AD Issued in MA
Practice address
400 West Cummings PK
Suite 3300
Woburn, MA 01801
Phone
(781) 938-1138
Fax
(781) 938-0406
NPI assigned
Sep 6, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0873AD MA Primary
Social Worker 104100000X 103356 MA

Addresses

Primary practice location

400 West Cummings PK
Suite 3300
Woburn, MA 01801

Mailing address

12 Euclid Avenue
Winchester, MA 01890
Phone (781) 721-1373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20050922000301 MA Practitioner - Clinical Social Worker 8729012430 Practice locations: Woburn, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

400 W Cummings Park
Woburn, MA 01801-6508
Phone (781) 938-1138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0873ADMAMDAddiction (Substance Use Disorder) Counselor
1032356MAMDSocial Worker
103356MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1821191123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EUCLID AVENUE",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "01890",
            "telephone_number": "781-721-1373",
            "fax_number": "781-938-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WEST CUMMINGS PK",
            "address_2": "SUITE 3300",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-938-1138",
            "fax_number": "781-938-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "LICSW CADAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "0873AD",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "103356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.