Roula Agne, LCSW

Individual provider Active NPI Clinical Social Worker · Missoula, MT

NPI 1285057232 · NPPES record last updated Aug 6, 2026

Key facts

NPI
1285057232
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
4642 (MT)
Practice address
107 W Sussex Ave
Missoula, MT 59801-6844
Phone
(406) 531-2416
Fax
(855) 201-3734
NPI assigned
Jan 28, 2014
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

107 W Sussex Ave
Missoula, MT 59801-6844
Phone (406) 531-2416

415 N Higgins Ave
Suite 9
Missoula, MT 59802-4559
Phone (406) 531-2416

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20171005001381 MT Practitioner - Clinical Social Worker 2365717048 Reassigns benefits to 1 organization
Practice locations: Missoula, MT

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4642MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roula Agne LCSW LLC Clinical Current
since Jun 20, 2005
Accepting new patients
Sydney D Seyfert Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4642 MT Yes

Addresses

Primary practice location

107 W Sussex Ave
Missoula, MT 59801-6844

Mailing address

PO Box 3236
Missoula, MT 59806-3236
Phone (406) 531-2416

Other identifiers

IdentifierTypeStateIssuer
1285057232MedicaidMT

Other providers in Missoula, MT

All providers in Missoula, MT · Clinical Social Worker in Montana

Sources for this page

Verify at the official NPI Registry.