Individual provider Active NPI

Kyle Stansbury, LCSW

  • Clinical Social Worker
  • Whitefish, MT
National Provider Identifier
1023395464
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18040 Issued in MT
Practice address
77 Crestwood Dr
Whitefish, MT 21275-9194
Phone
(406) 530-9977
NPI assigned
Nov 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18040 MT Primary

Addresses

Primary practice location

77 Crestwood Dr
Whitefish, MT 21275-9194

Mailing address

77 Crestwood Dr
Whitefish, MT 59937-3426
Phone (406) 530-9977

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
18040MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Logan Health - Whitefish Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1023395464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 CRESTWOOD DR",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599373426",
            "telephone_number": "406-530-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CRESTWOOD DR",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "212759194",
            "telephone_number": "406-530-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANSBURY",
        "first_name": "KYLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-14",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "18040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitefish, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.