Individual provider Active NPI

Daniel Brzozowski, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1124033006
Registry record updated Jul 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
458 Issued in MT
Practice address
1315 Wyoming St
Missoula, MT 59801-1725
Phone
(406) 532-9700
NPI assigned
Jul 30, 2006
Last updated
Jul 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2009

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 458 MT Primary

Addresses

Primary practice location

1315 Wyoming St
Missoula, MT 59801-1725

Mailing address

T-9 Fort Missoula
Missoula, MT 59804-7202
Phone (406) 532-9700

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
I20101102000364 MT Practitioner - Clinical Social Worker 6406040617 Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

415 N Higgins
Suite 119
Missoula, MT 59802-4561
Phone (406) 274-8210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hillside Health Care Center, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248048000000",
    "number": "1124033006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "T-9 FORT MISSOULA",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047202",
            "telephone_number": "406-532-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 WYOMING ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011725",
            "telephone_number": "406-532-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRZOZOWSKI",
        "first_name": "DANIEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2009-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.