Active NPI
Jop Geurtjens, LCSW
- Clinical Social Worker
- Missoula, MT
National Provider Identifier
1316508609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 37775
- Practice address
- 900 N Orange St Ste 103
Missoula, MT 59802-2951 - Phone
- (406) 327-3034
- Fax
- (406) 327-3385
- NPI assigned
- Jun 26, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 37775 | MT | Primary |
Addresses
Primary practice location
900 N Orange St Ste 103
Missoula, MT 59802-2951
Mailing address
900 N Orange St Ste 103
Missoula, MT 59802-2951
Phone (406) 327-3034
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37775 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1316508609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 N ORANGE ST STE 103",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598022951",
"telephone_number": "406-327-3034",
"fax_number": "406-327-3385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N ORANGE ST STE 103",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598022951",
"telephone_number": "406-327-3034",
"fax_number": "406-327-3385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEURTJENS",
"first_name": "JOP",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-26",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "37775",
"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 Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.