Individual provider Active NPI

Julie Anne Colibri, MSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1053777011
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61433369 Issued in WA
Practice address
1690 Milwaukee Way Apt 205
Missoula, MT 59801-3028
Phone
(360) 280-7593
NPI assigned
Jan 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-66547 MT
Clinical Social Worker 1041C0700X LW61433369 WA Primary

Addresses

Primary practice location

1690 Milwaukee Way Apt 205
Missoula, MT 59801-3028

Mailing address

1690 Milwaukee Way Apt 205
Missoula, MT 59801-3028
Phone (360) 280-7593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240908000100 MT Practitioner - Clinical Social Worker 9931649753 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCSW-LIC-66547MTMDClinical Social Worker
LW61433369WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Colibri Wellness PLLC Clinical CurrentSince Aug 27, 2024 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": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1053777011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 MILWAUKEE WAY APT 205",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013028",
            "telephone_number": "360-280-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 MILWAUKEE WAY APT 205",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013028",
            "telephone_number": "360-280-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLIBRI",
        "first_name": "JULIE",
        "middle_name": "ANNE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-66547",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61433369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.