Active NPI
Logan Montgomery, LLPC
- Professional Counselor
- Grand Rapids, MI
National Provider Identifier
1992328850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6451024366
- Practice address
- 2220 Wealthy St SE
Grand Rapids, MI 49506-3016 - Phone
- (616) 277-7533
- NPI assigned
- May 26, 2020
- Reactivated
- Jun 25, 2025
- 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 | 6451024366 | MI | Primary |
Addresses
Primary practice location
2220 Wealthy St SE
Grand Rapids, MI 49506-3016
Mailing address
925 Lake Michigan Dr NW
Grand Rapids, MI 49504-5642
Phone (231) 670-1221
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 |
|---|---|---|---|
| 6451024366 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751328000000",
"number": "1992328850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 LAKE MICHIGAN DR NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045642",
"telephone_number": "231-670-1221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2220 WEALTHY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495063016",
"telephone_number": "616-277-7533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "LOGAN",
"credential": "LLPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-26",
"last_updated": "2025-07-01",
"certification_date": "2025-07-01",
"deactivation_date": "2025-06-05",
"reactivation_date": "2025-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6451024366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.