Julie Anna Dalrymple, LCSW
Individual provider Active NPI Clinical Social Worker · Polson, MT
NPI 1477946341 · NPPES record last updated Apr 28, 2021
Key facts
- NPI
- 1477946341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SWP-LCSW-LIC-11534 (MT)
- Practice address
- 1201 Main St Ste B
Polson, MT 59860-5328 - Phone
- (406) 883-1718
- Fax
- (406) 204-1207
- NPI assigned
- Mar 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200921001610 | MT | Practitioner - Clinical Social Worker | 8224456405 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWP-LCSW-LIC-11534 | MT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kickin It Enterprises | Clinical | Current |
Accepting new patients |
Locations
1201 Main St
Ste B
Polson, MT 59860
Phone (406) 883-1718
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SWP-LCSW-LIC-11534 | MT | Yes |
Addresses
Primary practice location
1201 Main St Ste B
Polson, MT 59860-5328
Mailing address
1201 Main St
Ste B
Polson, MT 59860-5328
Phone (406) 883-1718
Other practice location 1
102 7th Ave NW
Choteau, MT 59422-9132
Phone (406) 466-5364 ext. 105
Other providers in Polson, MT
- Stephanie Courville
- Credena Health LLC
- Credena Health LLC
- Aaliyah Cunningham
- Gina Dalrymple
- Daniel a Gullotta PT
- Whitney Danz
- Darci Jones, LCSW, LLC
- Amanda Darling
- Heather Alyse Day
All providers in Polson, MT · Clinical Social Worker in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.