Individual provider Active NPI

Rebecca Kwon, MSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1366062515
Registry record updated Mar 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
52429 Issued in MT
Practice address
700 SW Higgins Ave Ste 109
Missoula, MT 59803-1489
Phone
(406) 200-8580
NPI assigned
Apr 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X BBH-SWLC-LIC-38869 MT
Clinical Social Worker 1041C0700X 52429 MT Primary

Addresses

Primary practice location

700 SW Higgins Ave Ste 109
Missoula, MT 59803-1489

Mailing address

700 SW Higgins Ave Ste 109
Missoula, MT 59803-1489
Phone (406) 200-8580

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
I20220324000320 MT Practitioner - Clinical Social Worker 4082009386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

700 SW Higgins Ave
Suite 109
Missoula, MT 59803-1489
Phone (406) 200-8580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52429MTMDClinical Social Worker
BBH-SWLC-LIC-38869MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Becca Kwon, LLC Clinical CurrentSince Mar 22, 2022 Accepting new patients
Serenity in Motion LLC Multi-Specialty PastSince Apr 1, 2020 Accepting new patients

Locations

700 SW Higgins Ave
Ste 109
Missoula, MT 59803
Phone (208) 946-1199

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647734400000",
    "number": "1366062515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SW HIGGINS AVE STE 109",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031489",
            "telephone_number": "406-200-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW HIGGINS AVE STE 109",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031489",
            "telephone_number": "406-200-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "REBECCA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-SWLC-LIC-38869",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "52429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.