Individual provider Active NPI

Tia Utzinger, LCSW

  • Clinical Social Worker
  • Bozeman, MT
National Provider Identifier
1346636099
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-LIC-555 Issued in MT
Practice address
937 Highland Blvd Ste 5410
Bozeman, MT 59715-6916
Phone
(406) 414-2400
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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 LCSW-LIC-555 MT Primary

Addresses

Primary practice location

937 Highland Blvd Ste 5410
Bozeman, MT 59715-6916

Mailing address

915 Highland Blvd
Attn PFS Credentialing
Bozeman, MT 59715-6902
Phone (406) 414-5000

Other identifiers 1

IdentifierTypeStateIssuer
1346636099MedicaidMT

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
I20160824002937 MT Practitioner - Clinical Social Worker 6709171135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

614 S Ferguson Ave
Suite 3
Bozeman, MT 59718-6413
Phone (406) 579-9011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-LIC-555MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bozeman Health Deaconess Hospital Current Accepting new patients
Bozeman Health Deaconess Hospital CurrentSince Aug 1, 2019 Accepting new patients
Bozeman Health Deaconess Hospital CurrentSince Aug 1, 2019 Accepting new patients
Tia Utzinger PLLC Clinical CurrentSince Jul 20, 2020 Accepting new patients

Locations

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

925 Highland Blvd
Ste 1220
Bozeman, MT 59715
Phone (406) 414-3780

501 E Peach St
Bozeman, MT 59715
Phone (406) 579-9011

614 S Ferguson Ave
Ste 3
Bozeman, MT 59718
Phone (406) 579-9011

937 Highland Blvd
Ste 5410
Bozeman, MT 59715
Phone (406) 414-2400

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1346636099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "address_2": "ATTN PFS CREDENTIALING",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 HIGHLAND BLVD STE 5410",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156916",
            "telephone_number": "406-414-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTZINGER",
        "first_name": "TIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2020-10-26",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "LCSW-LIC-555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346636099",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.