Organization Active NPI

M & M Counseling & Assessment Services, P.a.

  • Clinical Psychologist
  • San Angelo, TX
National Provider Identifier
1992178396
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
25043 Issued in TX
Legal business name
M & M COUNSELING & ASSESSMENT SERVICES, P.A.
Practice address
2501 Dena Dr
San Angelo, TX 76904-5014
Phone
(325) 223-0786
Fax
(325) 617-4196
NPI assigned
Nov 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Authorized official

Name
Dr. William Atterbury Montgomery, PH.D.
Title
President
Phone
(325) 223-0786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 25043 TX Primary

Addresses

Primary practice location

2501 Dena Dr
San Angelo, TX 76904-5014

Mailing address

2501 Dena Dr
San Angelo, TX 76904-5014
Phone (325) 223-0786

Other identifiers 1

IdentifierTypeStateIssuer
112989202MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1992178396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 DENA DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045014",
            "telephone_number": "325-223-0786",
            "fax_number": "325-617-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 DENA DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045014",
            "telephone_number": "325-223-0786",
            "fax_number": "325-617-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & M COUNSELING & ASSESSMENT SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ATTERBURY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "325-223-0786",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "25043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112989202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.