Kevin J Montague, MS, LPC, LSAC, LSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6332-125 Issued in WI

Practice address

100 Polk County PLZ
Ste 50
Balsam Lake, WI 54810-9071

Phone

(715) 485-8862

Fax

(715) 485-8450

NPI assigned

Feb 23, 2012

Last updated

May 10, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Polk County-Dept of AdministrationGroup PAC ID 4587560586, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Polk County Dept of Administration

  • Community/Behavioral Health Agency
  • Balsam Lake, WI
  • NPI 1083837298
  Medicare reassignment Care Compare group NPD
• Polk County-Dept of Administration

  dba Polk County Health Dept/Healthcheck

  • Public Health or Welfare Agency
  • Balsam Lake, WI
  • NPI 1295964435
  NPD

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1992078828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POLK COUNTY PLZ",
            "address_2": "STE 50",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548109071",
            "telephone_number": "715-485-8862",
            "fax_number": "715-485-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POLK COUNTY PLZ",
            "address_2": "STE 50",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548109071",
            "telephone_number": "715-485-8862",
            "fax_number": "715-485-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MS, LPC, LSAC, LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-23",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "8078-120",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15908-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6332-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Loeffler
• Anita Lundquist, PHARMD
• Kathleen M McGurran, LSW
• Brian Longhurst Merrill, DO
• Sara C Meuth, MSW APSW
• David N Moore, LSW
• Gerry R Morgan, LSW
• Emily C Ovik, SW LSW
• Cynthia J Peer, MS, LPC, LSAC, LSW
• Gail Peterson

• Professional Counselor in Balsam Lake, WI
• Providers in Balsam Lake, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.