Individual provider Active NPI

Abigail Guza, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1356885602
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19762 Issued in MT
Practice address
800 Kensington Ave Ste LL2
Missoula, MT 59801-5670
Phone
(406) 546-2665
NPI assigned
Dec 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 19762 MT Primary

Addresses

Primary practice location

800 Kensington Ave Ste LL2
Missoula, MT 59801-5670

Mailing address

2615 Arcadia Dr
Missoula, MT 59803-2020
Phone (406) 459-6989

Other practice location 1

800 Kensington Ave Ste 100
Missoula, MT 59801-5670
Phone (406) 546-2665

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
I20180507001696 MT Practitioner - Clinical Social Worker 8729342399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19762MTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356885602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 ARCADIA DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598032020",
            "telephone_number": "406-459-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KENSINGTON AVE STE LL2",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015670",
            "telephone_number": "406-546-2665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Kensington Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598015670",
            "country_code": "US",
            "telephone_number": "406-546-2665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZA",
        "first_name": "ABIGAIL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "19762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.