Active NPI
Diane Montgomery-Logan, MA
- Group Psychotherapy Psychologist
- Winooski, VT
National Provider Identifier
1962504183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Group Psychotherapy Psychologist
- License
- 534
- Practice address
- 99 Hall St
Winooski, VT 05404-1738 - Phone
- (802) 860-9500
- Fax
- (802) 655-3963
- NPI assigned
- Sep 1, 2006
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 534 | VT | |
| Group Psychotherapy Psychologist | 103TP2701X | 534 | VT | Primary |
Addresses
Primary practice location
99 Hall St
Winooski, VT 05404-1738
Mailing address
99 Hall St
Winooski, VT 05404-1738
Phone (802) 860-9500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004148 | Medicaid | VT |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 534 | VT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1962504183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 HALL ST",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054041738",
"telephone_number": "802-860-9500",
"fax_number": "802-655-3963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 HALL ST",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054041738",
"telephone_number": "802-860-9500",
"fax_number": "802-655-3963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY-LOGAN",
"first_name": "DIANE",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-01",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VT",
"license": "534",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "VT",
"license": "534",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1004148",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winooski, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.