Individual provider Active NPI

Bernard Montague Jr., LCSW

  • Mental Health Counselor
  • Westampton, NJ
National Provider Identifier
1912362880
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW132374 Issued in PA
Practice address
770 Woodlane Rd
Westampton, NJ 08060-3804
Phone
(609) 267-5928
NPI assigned
Dec 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05843300 NJ
Mental Health Counselor 101YM0800X SW132374 PA Primary

Addresses

Primary practice location

770 Woodlane Rd
Westampton, NJ 08060-3804

Mailing address

770 Woodlane Rd
Westampton, NJ 08060-3804
Phone (609) 267-5928

Other names 1

  • Jay Montague Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW132374PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Treatment Services Inc Current Accepting new patients

Locations

1289 Route 38
Ste 203
Hainesport, NJ 08036
Phone (609) 267-1377

795 Woodlane Rd
Westampton, NJ 08060
Phone (609) 261-4970

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": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1912362880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 WOODLANE RD",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080603804",
            "telephone_number": "609-267-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 WOODLANE RD",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080603804",
            "telephone_number": "609-267-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "BERNARD",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-21",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05843300",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "SW132374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "MONTAGUE",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Westampton, NJ

Sources for this page

Verify at the official NPI Registry.