Individual provider Active NPI

Madyson Jo Hintz, LCSW

  • Clinical Social Worker
  • Bismarck, ND
National Provider Identifier
1154092401
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6090 Issued in ND
Practice address
1237 W Divide Ave Ste 5
Bismarck, ND 58501-1208
Phone
(701) 328-8888
Fax
(701) 328-8900
NPI assigned
Sep 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 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 6090 ND Primary

Addresses

Primary practice location

1237 W Divide Ave Ste 5
Bismarck, ND 58501-1208

Mailing address

1237 W Divide Ave Ste 5
Bismarck, ND 58501-1208
Phone (701) 328-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20250129000753 ND Practitioner - Clinical Social Worker 2769911254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Behavioral Health Clinic CurrentSince Dec 10, 2024 Accepting new patients
The Kid'S Therapy Center LLC PastSince Oct 1, 2021 Accepting new patients

Locations

1237 W Divide Ave
Ste 5
Bismarck, ND 58501
Phone (701) 328-8888

Organizations & group practices 2

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": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1154092401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE STE 5",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011208",
            "telephone_number": "701-328-8888",
            "fax_number": "701-328-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTZ",
        "first_name": "MADYSON",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "6090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.