Individual provider Active NPI

Olivia Hockenbroch, SWLC

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1093449191
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-SWLC-LIC-56639 Issued in MT
Practice address
3819 Stephens Ave Ste 300
Missoula, MT 59801-8522
Phone
(406) 215-2225
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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-SWLC-LIC-56639 MT Primary

Addresses

Primary practice location

3819 Stephens Ave Ste 300
Missoula, MT 59801-8522

Mailing address

PO Box 3138
Missoula, MT 59806-3138
Phone (717) 525-0074

Other identifiers 1

IdentifierTypeStateIssuer
BBH-SWLC-LIC-56639OtherMTSWLC

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL iCloud Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BBH-SWLC-LIC-56639MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Missoula Therapy, PLLC CurrentSince Jul 17, 2022 Accepting new patients

Locations

3819 Stephens Ave
Ste 300
Missoula, MT 59801
Phone (406) 215-2225

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": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1093449191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3138",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598063138",
            "telephone_number": "717-525-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 STEPHENS AVE STE 300",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018522",
            "telephone_number": "406-215-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCKENBROCH",
        "first_name": "OLIVIA",
        "credential": "SWLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-SWLC-LIC-56639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWLC",
            "identifier": "BBH-SWLC-LIC-56639",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "iCloud",
            "affiliation": "N",
            "endpointDescription": "Missoula Therapy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3819 Stephens Ave Ste 300",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598018522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.