Individual provider Active NPI

Angela Dailey, LCSW

  • Clinical Social Worker
  • Fairfield, MT
National Provider Identifier
1083751283
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
255 Issued in MT
Practice address
423 Central Ave
Fairfield, MT 59436
Phone
(406) 467-2700
NPI assigned
Jan 30, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 255 MT Primary

Addresses

Primary practice location

423 Central Ave
Fairfield, MT 59436

Mailing address

221 10TH LN SW
Fairfield, MT 59436-9527

Other identifiers 1

IdentifierTypeStateIssuer
0502151MedicaidMT

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
I20100727000484 MT Practitioner - Clinical Social Worker 1052444106 Practice locations: Fairfield, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

423 Central Ave
Fairfield, MT 59436-6505
Phone (406) 467-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
255MTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083751283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 10TH LN SW",
            "city": "FAIRFIELD",
            "state": "MT",
            "postal_code": "594369527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 CENTRAL AVE",
            "city": "FAIRFIELD",
            "state": "MT",
            "postal_code": "59436",
            "telephone_number": "406-467-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAILEY",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0502151",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, MT

Sources for this page

Verify at the official NPI Registry.