Individual provider Active NPI

Sheri Montgomery, LMFT

  • Marriage & Family Therapist
  • Fort Myers, FL
National Provider Identifier
1942658414
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT4374 Issued in FL
Practice address
12811 Kenwood LN Ste 202
Fort Myers, FL 33907-5646
Phone
(239) 537-9646
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT4374 FL Primary
Marriage & Family Therapist 106H00000X 202014 TX

Addresses

Primary practice location

12811 Kenwood LN Ste 202
Fort Myers, FL 33907-5646

Mailing address

12811 Kenwood LN Ste 202
Fort Myers, FL 33907-5646
Phone (239) 537-9646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231118000325 FL Practitioner - Marriage and Family Therapist 4688022304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Therapy Treatment Team LLCGroup PAC ID 0446594451, 22 clinicians

Practice addresses (Care Compare)

12811 Kenwood LN
Suite 202
Fort Myers, FL 33907-5646
Phone (239) 537-9646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202014TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Treatment Team LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

12811 Kenwood Ln
Ste 202
Fort Myers, FL 33907
Phone (239) 537-9646

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": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1942658414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12811 KENWOOD LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075646",
            "telephone_number": "239-537-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 KENWOOD LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075646",
            "telephone_number": "239-537-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "SHERI",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4374",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "202014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.