Individual provider · Type 1 NPI

Ellen Petacque Montgomery

Clinical Social Worker · Chicago, IL

NPI number 1104625805 Active

Practice location

1743 N Sedgwick St
Chicago, IL 60614-5721

Call (312) 318-0260 Map

Other practice locations

  • 1743 N Sedgwick St, Chicago, IL 60614-5721 · (312) 318-0260

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X149007355 (IL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104625805

Ellen Petacque Montgomery's National Provider Identifier is 1104625805, issued on Mar 13, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Chicago, IL. The record was last updated on Mar 13, 2025.