Individual provider Active NPI

Garrett Clayton Epperson, LCSW

  • Social Worker
  • Kalispell, MT
National Provider Identifier
1629590179
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
BBH-SWLC-LIC-19414 Issued in MT
Practice address
30 E Washington St Ste C
Kalispell, MT 59901-3967
Phone
(406) 253-2793
NPI assigned
Jul 15, 2017
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X BBH-SWLC-LIC-19414 MT Primary
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-39132 MT

Addresses

Primary practice location

30 E Washington St Ste C
Kalispell, MT 59901-3967

Mailing address

30 E Washington St Ste C
Kalispell, MT 59901-3967
Phone (406) 253-2793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: No
  • 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
I20231211003061 MT Practitioner - Clinical Social Worker 1052760469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

507 10TH St W Westk
Kalispell, MT 59901-5564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-SWLC-LIC-19414MTMDSocial Worker
BBH-LCSW-LIC-39132MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical of Michigan PC CurrentSince Nov 1, 2023 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

Organizations & group practices 1

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": "1500076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1629590179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E WASHINGTON ST STE C",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013967",
            "telephone_number": "406-253-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E WASHINGTON ST STE C",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013967",
            "telephone_number": "406-253-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPERSON",
        "first_name": "GARRETT",
        "middle_name": "CLAYTON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-15",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MT",
            "license": "BBH-SWLC-LIC-19414",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-39132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.