Individual provider Active NPI

Michael James Monfils, LISW

  • Clinical Social Worker
  • Burlington, IA
National Provider Identifier
1265804272
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00459 Issued in IA
Practice address
400 S Broadway St
Burlington, IA 52601-9407
Phone
(319) 752-4000
Fax
(319) 752-6933
NPI assigned
Oct 29, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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 00459 IA Primary

Addresses

Primary practice location

400 S Broadway St
Burlington, IA 52601-9407

Mailing address

400 S Broadway St
Burlington, IA 52601-9407
Phone (319) 752-4000

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

LicenseStateTypeSpecialty
00459IAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1265804272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019407",
            "telephone_number": "319-752-4000",
            "fax_number": "319-752-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019407",
            "telephone_number": "319-752-4000",
            "fax_number": "319-752-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONFILS",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "00459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.