Active NPI
Ebony Theresa Montgomery, LPC
- Professional Counselor
- Ypsilanti, MI
National Provider Identifier
1932543733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401013178
- Practice address
- 555 Towner St.
Ypsilanti, MI 48198 - Phone
- (734) 544-3050
- Fax
- (734) 544-2906
- NPI assigned
- Apr 23, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401013178 | MI | Primary |
Addresses
Primary practice location
555 Towner St.
Ypsilanti, MI 48198
Mailing address
555 Towner St
P.O. Box 915
Ypsilanti, MI 48198-5752
Phone (734) 544-3050
Other practice location 1
1785 W Stadium Blvd Ste 203C
Ann Arbor, MI 48103-5291
Phone (734) 913-1093
Other names 1
- Ms. Ebony Theresa Pierre
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401013178 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heron Ridge Associates PLC | 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.
-
- Counselor
- Brighton, MI
- NPI 1144810946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540771200000",
"number": "1932543733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 TOWNER ST",
"address_2": "P.O. BOX 915",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481985752",
"telephone_number": "734-544-3050",
"fax_number": "734-544-2906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 TOWNER ST.",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "48198",
"telephone_number": "734-544-3050",
"fax_number": "734-544-2906"
}
],
"practiceLocations": [
{
"address_1": "1785 W Stadium Blvd Ste 203C",
"address_purpose": "LOCATION",
"city": "Ann Arbor",
"state": "MI",
"postal_code": "481035291",
"country_code": "US",
"telephone_number": "734-913-1093",
"fax_number": "734-369-2683",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "EBONY",
"middle_name": "THERESA",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-23",
"last_updated": "2018-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401013178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EBONY",
"last_name": "PIERRE",
"middle_name": "THERESA",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.