Individual provider Active NPI

Lisa Zug, LCSW

  • Clinical Social Worker
  • Kalispell, MT
National Provider Identifier
1083079735
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-13583 Issued in MT
Practice address
410 Windward Way
Kalispell, MT 59901-2680
Phone
(406) 257-1336
Fax
(406) 257-1353
NPI assigned
Dec 23, 2015
Last updated
Dec 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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 BBH-LCSW-LIC-13583 MT Primary

Addresses

Primary practice location

410 Windward Way
Kalispell, MT 59901-2680

Mailing address

410 Windward Way
Kalispell, MT 59901-2680
Phone (406) 257-1336

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
BBH-LCSW-LIC-13583MTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1083079735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 WINDWARD WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012680",
            "telephone_number": "406-257-1336",
            "fax_number": "406-257-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 WINDWARD WAY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012680",
            "telephone_number": "406-257-1336",
            "fax_number": "406-257-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUG",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-13583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.