Individual provider Active NPI

Deborah Wilson, LCSW

  • Clinical Social Worker
  • Bozeman, MT
National Provider Identifier
1093476939
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-70248 Issued in MT
Practice address
321 E Main St Ste 317
Bozeman, MT 59715-4721
Phone
(406) 579-2743
NPI assigned
Jan 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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-70248 MT Primary

Addresses

Primary practice location

321 E Main St Ste 317
Bozeman, MT 59715-4721

Mailing address

2950 Upper Rainbow Rd
Bozeman, MT 59718-7647
Phone (406) 579-2743

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
I20241114002745 MT Practitioner - Clinical Social Worker 0648704528 Practice locations: Bozeman, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 E Main St
Suite 317
Bozeman, MT 59715-4721
Phone (406) 224-6025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kind Counseling of Montana Clinical CurrentSince Oct 1, 2024 Accepting new patients

Locations

321 E Main St
Ste 317
Bozeman, MT 59715
Phone (406) 224-6025

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1093476939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 UPPER RAINBOW RD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187647",
            "telephone_number": "406-579-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E MAIN ST STE 317",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597154721",
            "telephone_number": "406-579-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEBORAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-70248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.