Individual provider Active NPI

Stephanie Quick, LCSW

  • Clinical Social Worker
  • Superior, MT
National Provider Identifier
1083036305
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
43917 Issued in MT
Practice address
405 Brooklyn St
Superior, MT 59872-9607
Phone
(406) 532-9150
NPI assigned
Jan 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3358 MT
Clinical Social Worker 1041C0700X 43917 MT Primary

Addresses

Primary practice location

405 Brooklyn St
Superior, MT 59872-9607

Mailing address

405 Brooklyn Ave
Superior, MT 59872-9607
Phone (406) 822-4278

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
I20200922002763 MT Practitioner - Clinical Social Worker 8820416902 Reassigns benefits to 1 organization
Practice locations: Superior, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

204 4TH Ave E
Superior, MT 59872-9610
Phone (406) 218-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3358MTMDAddiction (Substance Use Disorder) Counselor
43917MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Partnership Health Center Inc CurrentSince Jul 13, 2020 Accepting new patients
Partnership Health Center Inc Current Accepting new patients
Partnership Health Center Inc CurrentSince Jul 13, 2020 Accepting new patients

Locations

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

405 Brooklyn Ave
Superior, MT 59872
Phone (406) 532-9150

Organizations & group practices 3

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": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1083036305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BROOKLYN AVE",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729607",
            "telephone_number": "406-822-4278",
            "fax_number": "406-258-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BROOKLYN ST",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729607",
            "telephone_number": "406-532-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUICK",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "3358",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "43917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, MT

Sources for this page

Verify at the official NPI Registry.