Individual provider Active NPI

Stephanie I Reichhardt, LCSW

  • Clinical Social Worker
  • Butte, MT
National Provider Identifier
1184721060
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
733 Issued in MT
Practice address
690 S Excelsior Ave
Butte, MT 59701-2232
Phone
(406) 491-1439
Fax
(406) 299-3772
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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 733 MT Primary

Addresses

Primary practice location

690 S Excelsior Ave
Butte, MT 59701-2232

Mailing address

690 S Excelsior Ave
Butte, MT 59701-2232
Phone (406) 491-1439

Other identifiers 2

IdentifierTypeStateIssuer
0503867MedicaidMT
000071425OtherMTBCBS

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
I20120117000001 MT Practitioner - Clinical Social Worker 4789851726 Practice locations: Butte, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

690 S Excelsior Ave
Butte, MT 59701-2232
Phone (406) 491-1439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
733MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology of Montana, PLLC PastSince Sep 15, 2019 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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1184721060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 S EXCELSIOR AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597012232",
            "telephone_number": "406-491-1439",
            "fax_number": "406-299-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S EXCELSIOR AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597012232",
            "telephone_number": "406-491-1439",
            "fax_number": "406-299-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHHARDT",
        "first_name": "STEPHANIE",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0503867",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000071425",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butte, MT

Sources for this page

Verify at the official NPI Registry.