Individual provider Active NPI

Shonda Montroy, LMSW

  • Social Worker
  • Okemos, MI
National Provider Identifier
1881103513
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801109090 Issued in MI
Practice address
2149 Jolly Rd Ste 500
Okemos, MI 48864-6028
Phone
(517) 347-4645
Fax
(517) 347-4644
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S1201463 OH
Social Worker 104100000X 6801109090 MI Primary

Addresses

Primary practice location

2149 Jolly Rd Ste 500
Okemos, MI 48864-6028

Mailing address

2149 Jolly Rd Ste 500
Okemos, MI 48864-6028
Phone (517) 347-4645

Other practice location 1

6435 E Broad St
Columbus, OH 43213-1507
Phone (614) 355-8160

Other identifiers 1

IdentifierTypeStateIssuer
2846675MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210324002775 MI Practitioner - Clinical Social Worker 6800203597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2149 Jolly Rd
Suite 500
Okemos, MI 48864-6028
Phone (517) 347-4645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801109090MIMDSocial Worker
S1201463OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Gallagher LMSW Acsw Professional Counseling SRVS LLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

2149 Jolly Rd
Ste 500
Okemos, MI 48864
Phone 5173474645102

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1881103513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 JOLLY RD STE 500",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646028",
            "telephone_number": "517-347-4645",
            "fax_number": "614-355-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 JOLLY RD STE 500",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646028",
            "telephone_number": "517-347-4645",
            "fax_number": "517-347-4644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6435 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131507",
            "country_code": "US",
            "telephone_number": "614-355-8160",
            "fax_number": "614-355-8180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTROY",
        "first_name": "SHONDA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1201463",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801109090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.