Individual provider Active NPI

Maria Lee, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1477041671
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-30265 Issued in MT
Practice address
445 S 5TH St W
Missoula, MT 59801-2619
Phone
(404) 272-5558
NPI assigned
Apr 24, 2018
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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-LCSW-LIC-30265 MT Primary

Addresses

Primary practice location

445 S 5TH St W
Missoula, MT 59801-2619

Mailing address

800 Kensington Ave, Ste 208
Missoula, MT 59801
Phone (406) 272-5558

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
I20191113001336 MT Practitioner - Clinical Social Worker 2264864271 Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

445 S 5TH St W
Missoula, MT 59801-2619
Phone (406) 272-5558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Ferriter LLC CurrentSince May 29, 2016 Accepting new patients
Center for Positive Change LLC PastSince Mar 26, 2024 Accepting new patients
M.J.H.H., Inc. PastSince Dec 13, 2020 Accepting new patients

Locations

445 S 5th St W
Missoula, MT 59801
Phone (406) 523-5625

800 Kensington Ave
Ste 208
Missoula, MT 59801
Phone (406) 461-6784

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": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1477041671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 KENSINGTON AVE, STE 208",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59801",
            "telephone_number": "406-272-5558",
            "fax_number": "833-633-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S 5TH ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012619",
            "telephone_number": "404-272-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-30265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.