Individual provider Active NPI

Dustin Rifkin, LCSW

  • Clinical Social Worker
  • Jackson, WY
National Provider Identifier
1144603598
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1743 Issued in WY
Practice address
610 W Broadway Ave
Jackson, WY 83001-8213
Phone
(307) 733-3908
NPI assigned
Jul 2, 2015
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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 1743 WY Primary

Addresses

Primary practice location

610 W Broadway Ave
Jackson, WY 83001-8213

Mailing address

PO Box 11390
Jackson, WY 83002-1390
Phone (307) 733-3908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20260515002509 WY Practitioner - Clinical Social Worker 6204305527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

640 E Broadway Ave
Jackson, WY 83001-8642

755 E Hansen Ave Apt
316 13224
Jackson, WY 83002

PO Box
Suite 1868
Jackson, WY 83001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1743WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health & Recovery Services of Jackson Hole CurrentSince Apr 1, 2026 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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1144603598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11390",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830021390",
            "telephone_number": "307-733-3908",
            "fax_number": "307-734-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018213",
            "telephone_number": "307-733-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIFKIN",
        "first_name": "DUSTIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "1743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.