MONTE SOLOMON MEMMOTT (SSW) – Mental Health Counselor, NPI 1205928504

MONTE SOLOMON MEMMOTT (SSW) is a healthcare provider. based in Provo, Utah. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials SSW. They hold a License No. 5586544-6004 (UT). The NPI Number for MONTE SOLOMON MEMMOTT (SSW) is 1205928504

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
MONTE SOLOMON MEMMOTT (SSW)
NPI
1205928504
Phone
(801) 373-4760
Address
750 N FREEDOM BLVD
Enumeration Date
28 September 2006
Last Update Date
5 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8013734760
Graduation Year
2009 (17 years ago)
PAC ID
2860843356
Group Practice PAC ID
2567367915
Professional Enrollment ID
I20240109003326
Address ID
UT846011677PR750XXBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

356 MENTAL HEALTH COUNSELOR in UT

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Provider Addresses for MONTE SOLOMON MEMMOTT (SSW)

  • 750, Freedom Boulevard, North Park, Provo, Utah County, Utah, 84601, United States

    PROVO, UT 846011677

    Phone: (801) 373-4760

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240109003326IMental Health CounselorUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567367915View full group profile

Reviews

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Frequently asked questions

What identifier follows MONTE SOLOMON MEMMOTT (SSW) across health systems?
The NPI 1205928504 uniquely identifies MONTE SOLOMON MEMMOTT (SSW) in U.S. healthcare data.
Is MONTE SOLOMON MEMMOTT (SSW) currently accepting referrals based on NPI status?
Registry metadata lists MONTE SOLOMON MEMMOTT (SSW) as active.
What type of care does MONTE SOLOMON MEMMOTT (SSW) provide?
MONTE SOLOMON MEMMOTT (SSW)'s profile centers on Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is MONTE SOLOMON MEMMOTT (SSW) tied to Provo, Utah?
If you are local to Provo, Utah, MONTE SOLOMON MEMMOTT (SSW) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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