Individual provider Active NPI

Amy Gault, MSW

  • Clinical Social Worker
  • Kalispell, MT
National Provider Identifier
1376118661
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-SWLC-LIC-38947 Issued in MT
Practice address
307 1St Ave E Ste 16
Kalispell, MT 59901-4965
Phone
(406) 529-1104
Fax
(406) 730-5971
NPI assigned
May 20, 2021
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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 BBH-SWLC-LIC-38947 MT Primary

Addresses

Primary practice location

307 1St Ave E Ste 16
Kalispell, MT 59901-4965

Mailing address

PO Box 446
Kalispell, MT 59903-0446
Phone (406) 529-1104

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
I20221228000956 MT Practitioner - Clinical Social Worker 6507236031 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
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18 Cedar St
Anaconda, MT 59711-2308
Phone (406) 529-1104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-SWLC-LIC-38947MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Synchrony Therapeutic Services, PLLC Clinical CurrentSince Aug 31, 2022 Accepting new patients
Warrior2Veteran LLC Clinical CurrentSince Aug 25, 2024 Accepting new patients
Gypsy Ray LCSW LLC Clinical Past Accepting new patients
Jessica Curry LCSW PLLC PastSince Sep 4, 2022 Accepting new patients

Locations

18 Cedar St
Anaconda, MT 59711
Phone (406) 529-1104

209 Cherry St
Anaconda, MT 59711
Phone (406) 529-1104

1507 1st Ave W
Ste D
Kalispell, MT 59901
Phone (406) 270-3047

307 1st Ave E
Ste 16
Kalispell, MT 59901
Phone (406) 282-4770

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, 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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1376118661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599030446",
            "telephone_number": "406-529-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 1ST AVE E STE 16",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014965",
            "telephone_number": "406-529-1104",
            "fax_number": "406-730-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULT",
        "first_name": "AMY",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-SWLC-LIC-38947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.