Individual provider Active NPI

Nathan L Church, LCSW

  • Clinical Social Worker
  • Billings, MT
National Provider Identifier
1366742199
Registry record updated Apr 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1043 Issued in MT
Practice address
527 Lake Elmo Dr
Billings, MT 59105-3051
Phone
(406) 694-5000
Fax
(406) 245-1156
NPI assigned
Oct 27, 2010
Last updated
Apr 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1352 MT
Clinical Social Worker 1041C0700X 1043 MT Primary

Addresses

Primary practice location

527 Lake Elmo Dr
Billings, MT 59105-3051

Mailing address

540 Jemstone Dr
Billings, MT 59101-6854
Phone (406) 694-5000

Other identifiers 1

IdentifierTypeStateIssuer
1366742199MedicaidMT

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
I20120404000996 MT Practitioner - Clinical Social Worker 2466612155 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1245 N 29TH St
Billings, MT 59101-0122

2501 4TH Ave N
Billings, MT 59101-1317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1352MTMDAddiction (Substance Use Disorder) Counselor
1043MTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Montana Rescue Mission Addiction (Substance Use Disorder) CurrentSince Mar 1, 2020 Accepting new patients
Bodhi Tree Counseling, Inc Clinical CurrentSince Sep 25, 2019 Accepting new patients
South Central Montana Regional Mental Health Center CurrentSince May 31, 2017 Accepting new patients

Locations

1245 N 29th St
Billings, MT 59101
Phone (406) 252-5658

2902 Minnesota Ave
Billings, MT 59101
Phone (406) 259-3800

527 Lake Elmo Dr
Billings, MT 59105
Phone (406) 208-3255

Organizations & group practices 3

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": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1366742199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JEMSTONE DR",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591016854",
            "telephone_number": "406-694-5000",
            "fax_number": "406-245-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 LAKE ELMO DR",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591053051",
            "telephone_number": "406-694-5000",
            "fax_number": "406-245-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "NATHAN",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-27",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1352",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "1043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366742199",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.