Active NPI
Kelsey Walnum
- Clinical Social Worker
- Missoula, MT
National Provider Identifier
1184108250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 32066
- Practice address
- 1305 Wyoming St
Missoula, MT 59801-1725 - Phone
- (406) 532-9770
- NPI assigned
- Sep 24, 2018
- Last updated
- Sep 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 32066 | MT | Primary |
Addresses
Primary practice location
1305 Wyoming St
Missoula, MT 59801-1725
Mailing address
1305 Wyoming St
Missoula, MT 59801-1725
Phone (406) 532-9770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32066 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1184108250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 WYOMING ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598011725",
"telephone_number": "406-532-9770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 WYOMING ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598011725",
"telephone_number": "406-532-9770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALNUM",
"first_name": "KELSEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-24",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "32066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.