Dacia Lee Antiste-Fisher, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BBH-LCSW-LIC-30076 Issued in MT

Practice address

5 4TH Ave E
Polson, MT 59860-2117

Phone

(406) 745-3525

Fax

(406) 745-3529

NPI assigned

Nov 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dacia Lee Antiste Other name

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Confederated Salish and Kootenai Tribes of the Flathead Reservation 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Confederated Salish and Kootenai Tribes of the Flathead Reservation

  • Federally Qualified Health Center (FQHC)
  • Saint Ignatius, MT
  • NPI 1952402208

  MT

  Medicare reassignment Care Compare group NPD
• Confederated Salish & Kootenai Tribes of the Flathead Reservation

  • Community/Retail Pharmacy
  • Saint Ignatius, MT
  • NPI 1669502316
  NPD

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1104255637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 880",
            "city": "ST. IGNATIUS",
            "state": "MT",
            "postal_code": "59865",
            "telephone_number": "406-745-3525",
            "fax_number": "406-745-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 4TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598602117",
            "telephone_number": "406-745-3525",
            "fax_number": "406-745-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTISTE-FISHER",
        "first_name": "DACIA",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-30076",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1930",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "LAC-LAC-LIC-1930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DACIA",
            "last_name": "ANTISTE",
            "middle_name": "LEE",
            "credential": "LAC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Anne D Lowe LCSW
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• Kelly Garver Bagnell, M. D.
• Kim Barta, M.A., L.C.P.C.
• Elizabeth Nicole Bassler, LCSW

• All providers in Polson, MT
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.