Ivy Vanessa Irvine, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

924 Issued in MT

Practice address

2112 Dixon Ave
Missoula, MT 59801-8226

Phone

(406) 546-0082

NPI assigned

Aug 24, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bluebird Psychotherapy, PLLC

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1760848824
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467768705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1384",
            "city": "LOLO",
            "state": "MT",
            "postal_code": "59847",
            "telephone_number": "406-546-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 DIXON AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018226",
            "telephone_number": "406-546-0082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 W Alder St Ste 28",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024026",
            "country_code": "US",
            "telephone_number": "406-546-0082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRVINE",
        "first_name": "IVY",
        "middle_name": "VANESSA",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467768705",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Intentional Healing, LLC
• Interim Healthcare of Western Montana
• Meghan Elizabeth Intermill
• Intermountain Planned Parenthood
• Angela Marie Ireland, PA-C
• Katherine Isaacson, LCPC
• Stephanie Ammons Isbell, COUNSELOR
• Ambrosia Isely, LCSW, ACLC
• Taylor Isom
• Tara Ivanovitch, LCSW, LAC

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.